Congratulations on taking your first step toward setting your relationship up for success!

Please fill out the following form to register for our relationship coaching service. We email you to confirm your registration request with an electronic invoice within 48 hours.

Payment won’t be due until 14 days after you receive your invoice!

Partner 1 *

Partner 1

First Name

Last Name

Partner 1 Email Address *

Partner 1 Phone

(###)

###

####

Partner 1 Address *

Partner 1 Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Partner 2 *

Partner 2

First Name

Last Name

Partner 2 Email Address *

Partner 2 Phone *

Partner 2 Phone

(###)

###

####

Partner 2 Address

Leave blank if same as Partner 1 Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

What is your relationship status? *

Dating / In a Relationship

Engaged

Married

Non-married / Alternative Commitment

Do you have any children? *

Yes

Are you and your partner living together? *

It's great if you are! :) Knowing this will just help us to know where you're at!

Yes

Is there anything you'd like us to know about you?

e.g. have kids; recently moved in together; previously married; LGBTQ couple; consensually non-monogamous; etc.

Did someone refer you to us? If so, let us know so we can thank them!

Select your preferred payment schedule. *

An invoice with your indicated preference will be sent via email to you within 48 hours of your registration submission. Payment will be due 14 days from the receipt of your invoice!

PROMO CODE:

If you found us through an ad and have a promo code to apply, enter the promo code here and the discount will be applied to your invoice.

An invoice request will be sent to you within 48 hours of registration. Your registration will not be official until full payment has been received. Please complete your registration via payment within 14 days of receiving your invoice.

OUR CANCELLATION & REFUND POLICY [EFFECTIVE AS OF MARCH 2019]: Your registration payment* is 100% refundable if cancellation is requested at least 10 days prior to first scheduled coaching session. A 50% refund may be granted if cancellation is requested up to 9 days before or 5 days after the first scheduled session. Refunds will not be granted following the 8th day after the first scheduled session.
*GIFT CERTIFICATES ARE NONREFUNDABLE.
*Cancellation & Refund Policy subject to change without written or verbal notice.

To request a cancellation and refund, please email michelle@haveandhold.co // payton@haveandhold.co // or contact us at www.haveandhold.co/contact-us