Therapist Contract Agreement

Therapist Contract Agreement

Therapist Contract Agreement and Terms of Service

This is for therapists and service users who use our services.

Last updated August 2024

Please read these Therapist Terms of Service and Service Contract Agreement carefully before you begin using the Mithrah Therapy Platform as these will apply to your relationship with Mithrah. In using Mithrah Therapy Platform you agree to these Terms. This contract can be downloaded from the website and saved upon joining Mithrah. When joining, The Therapist will be asked to read this and give consent to it.

If The Therapist does not agree with any of the terms listed in this service contract, this service will not be suitable for them and hence we kindly request The Therapist to make this informed decision before choosing our service. The annual membership fee will not be refunded even if the client used our service for 30 minutes.

Important: The document is not case-sensitive. For example, the words – the therapist and The Therapist – represent the same.

Definitions

Agreement means the client’s acceptance of these Terms of Service.

The words such as ‘The Therapist’, ‘therapist’, ‘contractor’, and ‘sub-contractor’ in this document mean the therapist who takes or is planning to take a standard membership plan or a premium membership plan. They are not employed by Mithrah.

Client can mean both contractors and consumers who want to have therapy from the therapies of Mithrah. So please pay close attention to the context of the sentence in which this word is used.

The client also means the person requesting and engaging in services provided by the Mithrah Therapy Platform.

Session means any occurrence of an appointment booked by a Client or Therapist for the Client to receive any of the Therapist Services.

Mithrah Therapy Platform means the online platform or internet website through which the services are provided to the client being comprised within the domain www.mithrah.com or as may be changed or updated from time to time.

Mithrah Therapy platform may comprise all the services available on www.mithrah.com  and/or provided through Mithrah Therapy platforms for the users who intend or agree to use it and who can use it provided it is within the reasonable and practical scope of the website.

Therapists are denoted using various names such as contractors, sub-contractors, Mithrahs and therapists. They are from various disciplines such as psychiatry, psychology, psychotherapy, counselling, social work, community work, and etc.

The Platform or Online platform or Mithrah online platform or Mithrah platform or Mithrah therapy platform means the Mithrah Holistic Services.

Mithrah Holistic Services and Mithrah Therapy platform mean the same.

Mithrah Holistic Services means the owner of all intellectual property and services provided on the website and platform.

Therapist Services means the therapy services which the Therapist is in the business of providing to Clients.

Booking means a scheduled appointment with a Therapist booked by the Client via The Platform.

Therapist Content means any content added by the Therapist to the Mithrah Therapy Platform.

Disclaimer

This document may contain typos, grammar errors, printing mistakes, human errors or technical errors that may be unintentional or due to technology or any other issues. We will try to correct them when they are brought to our attention. However, we encourage you to clarify your doubts or concerns with us.

In addition to this contract, the therapists also agree that they agree to the terms and conditions found on the page: https://mithrah.com/terms-and-conditions/ , the Internet Privacy Policy found on the page: https://mithrah.com/privacy-policy/ and the Therapeutic Contract and Consent Details for Clients found on the page: https://mithrah.com/therapeutic-contract-and-consent-details-for-clients/.

Change of Therapist Contract Agreement

This contract can change or get updated without prior notice from time to time. We request the users of this service to check the contract at least once in every month.

DATA SECURITY

DATA SECURITY will be taken into high consideration and will not be compromised easily. However, the backup of all data regarding the service they provide must be taken care of by the therapist.  The internet is also a place with unpredictable risks due to the malicious intent of hackers and other online fraudulence. Other human errors may also be possible when a system is handled by various humans and professionals. While Mithrah takes due care and diligence, we do not offer any guarantee to the security of data related to the therapist or client seen by a therapist if it is beyond our control when there is a purposeful malicious intent or accidental human error. It has to be noted that many insurance companies do not cover online security issues and hence Mithrah also do not guarantee against such malicious intents and/or human error. Therapists who have great concerns about online data security and hacking-related issues are advised to make informed choices from using any of our services as we acknowledge the limitations that exist in conducting online and internet-based services.

Registration form details and process

We expect the therapist to provide legally accurate and correct information and documentation. All certificates and professional documents must be attested by relevant authorities of the country where the therapist practices.

We do not refund at any cost if you change your mind or provide incorrect information as we spend a significant amount of time verifying the information you provided us. This also helps us avoid being tricked by scammers.

We may take from one business week to several days for certain countries as we do complete reference checks. We can be contacted for any updates at any time via email. We may take up to two business days to respond to all your queries. All communication will be entertained via email only.

 Legal Jurisdiction

Mithrah is an Australian business. So all legal matters are subject to Australian law and can be conducted in relevant Australian courts and/or tribunals only.

Platform Software License

The Therapist’s use of the Platform is at the Therapist’s sole risk. The service is provided on an “as is” and “as available” basis.

Technical support is provided by email primarily and is a benefit for the Therapist, but is not a right of the Therapist.

The Therapist understands and accepts that the Mithrah Therapy Platform uses third-party vendors and hosting services to provide the hardware, software, networking, storage, and related technology required to run the Platform. The Therapist also acknowledges and agrees that Mithrah Holistic Services shall have administrator’s access to all parts of the Platform, including those parts that have been specifically tailored for the Therapist.

The Therapist shall not reproduce, duplicate, copy, sell, resell or exploit the whole or any part of the Platform, or allow any third party (including group companies of the Therapist) to use or access the Platform without express prior written permission from Mithrah Holistic Services.

Mithrah Platform does not warrant:

  • that the Platform will meet the Therapist’s specific requirements;
  • that the Platform will be uninterrupted, timely, secure, or error-free;
  • that any information or results that may be obtained from the use of the Platform will be accurate or reliable;
  • that the quality of any products, services, information, or other material purchased or obtained by the Therapist through the Platform will meet the Therapist’s requirements or expectations; or
  • that any errors in the Platform will be corrected or remain corrected.

The Therapist expressly understands and agrees that as regards the use of the Mithrah Therapy Platform shall not be liable for any loss of income or profits, loss of contracts, loss of goodwill, loss of data, or other intangible losses or for any indirect or consequential loss or damage.

Who can be the therapist in the Mithrah platform?

All therapists must meet the following criteria:

  • They must be legally allowed to carry on their profession advertised on this site to provide service in their respective countries
  • They must not have any criminal case on them
  • They must not have been banned from practising their profession by their regulatory bodies
  • They must meet their professional obligations to the associations they are members of

Permission to publish the Therapist’s data on the website

Therapist agree to publish their professional data, profile data and business data that they shared with us on the website. The data can be removed or updated upon request. Therapists also agree to allow us sufficient time to remove or update data. The accuracy of the published data must be verified by the therapist.

Validity of Service Contract

The service contract needs to be renewed each service year.  The service contract is valid for one year from the date of joining. E.g. 10/12/2023 -10/12/2024;  It is the responsibility of therapists who use the platform to renew the service contract if they want to use the platform for another year.

Inclusive Policies

We believe every human deserves Justice, equality, equity, diversity, and dignity.  We do not tolerate and support racism, discrimination, and special preferences and privileges of some races over others in unethical and unlawful ways. We expect our therapist to follow national and international human rights laws and obligations when practising their professional services.

Client Centric services

We also believe that the client should be given informed choices regarding the services and the therapist must always work around the therapeutic goals of the clients.  Therapist must not enforce a client to receive any service when the client do not want it.

Duty of Care

The therapist must always uphold the duty of care when they sue and or provide their service with or without Mithrah Therapy Services. The therapist must inform Mithrah when they are not able to serve clients effectively due to any reason. The safety and well-being of the client or public including the therapist should never be put at risk due to the information exchanged at therapy. All therapists must assume the responsibility of making voluntary mandatory reports with concerned government and/or NGO authorities including but not limited to Police when they see a risk or concern that may put someone at risk of harm.

Professional Obligations and Duties

All therapists must adhere to their professional obligations, duties and legal responsibilities at all times when they provide services or are on any temporary vacation. All therapists are expected to be aware of cultural sensitivity and safety when providing service to multicultural clients and communities. When a therapist provides services to international clients, they must know their limitations and boundaries. They should not provide services when they are not qualified and competent enough. The Therapist also should never mislead and/or misguide clients. Professional malpractices are strictly not tolerated.

Therapist Obligations

The Therapist agrees to pay all applicable commissions to Mithrah Holistic Services and to accept all bookings and may only decline to accept in exceptional circumstances.

The Therapist agrees to supply their services to the highest professional standards.

The Therapist must ensure they have valid and up-to-date liability insurance and understand it’s their sole responsibility to handle all claims that may arise from a Client who has booked their services via the Mithrah Therapy Platform. They understand that Mithrah Holistic Services is not responsible or liable for any claims made against them. The Therapists, must upon reasonable request by Mithrah Holistic Services, provide a copy of liability insurance.

Mithrah Therapeutic Model training

All therapists who become Mithrah or join our team may have to undertake the Mithrah Therapeutic model training every year to remain updated. This may be an online program or Zoom conference held from time to time which helps our therapist understand our therapeutic framework and integrative practice model along with the code of ethics and policies that need to be followed when using our Mithrah Therapy Platform. The registration fees include a fee for this training and we do not charge anything extra.

Cancellation Policy in general

The Therapist is obliged to comply with the cancellation and rescheduling policy set out in the Terms of Service. In summary:

Mithrah Holistic Services will offer a full refund to clients on bookings which are cancelled (or unable to be rescheduled) provided the relevant appointment is not due to take place within 48 hours of receipt by Mithrah Holistic Services of the cancellation.

If a Client wishes to change the date and/or time of a Session, provided the Client gives at least 48 hours’ notice prior to the time of the appointment, the Client can choose a suitable alternative Session time and/or date. In the event that a Therapist is unable or unwilling to accept a Booking following a Client requesting such a change, Mithrah Holistic Services will treat the Booking as cancelled by the Client and will refund the Client the full amount of the Booking.

If a therapist wishes to change the date and/or time of a Session, in the event that the Client is unable or unwilling to agree to such change, Mithrah Holistic Services will treat the Booking as cancelled by the Therapist and will refund the Client the full amount of the Booking.

Restraint of Trade

The Therapist shall not solicit Clients derived from the Mithrah Therapy Platform to make Bookings other than through The Platform. This includes initial consultations and all subsequent follow-up bookings.

Where a Client makes a Booking and the Therapist encourages that Client to cancel their Booking and make a separate Booking directly with the Therapist, the Therapist shall be in Breach of this Agreement.

If Mithrah Holistic Services has reasonable grounds to suspect that the Therapist has made or makes any direct or indirect attempt to avoid paying any Commission, for example without limitation, by fraudulently flagging a Session as a cancellation or non-chargeable, this shall be a Breach of this Agreement and shall give Mithrah Holistic Services the right, without limiting other remedies available to it, to withhold and retain any payments due to the Therapist under this Agreement.

Therapist Warranties and Indemnity

The Therapist hereby grants Mithrah Holistic Services the right:

  • to update this Agreement from time to time;
  • to use and publish the Therapist Content in connection with the provision of Mithrah Therapy Platform Services;
  • to remove, edit or cut down the Therapist Content where Mithrah Holistic Services sees fit; and
  • to use any Therapist Content in marketing material and on our social media tools and channels.

The Therapist warrants represents and undertakes that it shall comply with all applicable laws and advertising regulations in the marketing, sale and provision of the Therapist Services and shall obtain all licences, consents, authorities and insurance it is either necessary or reasonably prudent for the Therapist to obtain in respect of all its business activities and personnel.

The Therapist is aware and agrees that Mithrah Holistic Services is not responsible for any loss, damage, liability or negligence arising from its agreement or contract with Clients.

The Therapist also agrees to update any changes in their services or professional status immediately with Mithrah and with their clients.

Fees and Payment to use the services

What are Mithrah’s platform fees?

We charge a flat annual membership fee which may be subject to change. However, the fee will be valid for the one-year period to which the service contract is made.

Introductory plan: No annual service fee to join and try our platform for one year. Only 10% of the platform fee for the first year.

Flat membership fee:  $0 AUD for the Standard membership plan, $250 AUD for the premium membership plan.

The membership will be renewed automatically in case of a standard membership plan unless it is revoked explicitly in writing.

The premium membership plan must be renewed and paid annually. Otherwise, standard membership will continue in its place.

in addition to membership fees, each therapist will be charged a standard infrastructure fee per day regardless of the number of clients they see as it will be difficult to process a fee for the usage of the online platform by each therapist as we provide various resources and services online. This fee will vary from country to country as Mithrah understands the difficulties of developing and under-developing countries and upcoming professionals. Unless negotiated, the fixed fees for using the online Mithrah platform and other infrastructure per day is $20 AUD for developed countries such as Australia, New Zealand, UK, USA, Singapore, Qatar, Kuwait, UAE, Saudi Arabia, Bahrain, and European countries and $5 for underdeveloped and developing countries even if you see only one client. This fee is subject to change from time to time and will be notified on the website transparently.

The platform fee helps to keep the platform running and covers the cost of payment processing, video service, marketing, development and customer support.

What are the shared business places for Mithrah therapists?

Mithrah hires office spaces and common business venues for the use of its therapists and service users. These places will be known as shared business places. These shared business places will be available for therapists and service users at affordable membership plans and rates. However, these shared business places are not owned and maintained by Mithrah. Mithrah cannot guarantee the availability of these shared business spaces if the business that rents the places to Mithrah ends the lease or closes their places down for any reason. These shared business places are available subject to the conditions of the business that rents the place to Mithrah. The places being shared business places, privacy, confidentiality and liability cannot be guaranteed by Mithrah. The therapists and any service users must cooperate with the rules and regulations of both Mithrah, and the business that rents the shared business places to Mithrah.

Standard plan – $0 AUD

Standard membership plan – Free

The standard membership plan includes the following features:

  • Free Listing for therapists
  • A 20% processing fee will be charged from the fees of each client for using this platform and resources
  • Access to the Mithrah Therapy Online Platform
  • Standard 10% processing fees on the payments made by clients
  • Access to Mithrah face-to-face clinic at Parramatta, NSW, Australia upon booking. Access charges apply. Conditions apply.
  • Discount on CPD trainings facilitated by Mithrah
  • Affordable and competitive supervision by industry experts
  • Opportunity to avail of discounted Professional Indemnity and Public liability insurance
  • Access to subsidised debriefing services at $25 per session for 6 sessions a year. Please note that the therapists can be from overseas.
  • Discounts on network meetings when conducted
  • All services are subject to availability. There may be interruptions due to unavoidable circumstances such as natural calamities, cancellation of venues and/or office rooms due to reasons which are beyond Mithrah’s ability to control
  • Renewal is done automatically every year unless it is revoked by a member explicitly in writing.

Premium membership plan – $250 a year

The premium membership plan includes the following features:

  • All Standard plan features included
  • A 10% processing fee will be charged from the fees of each client for using this platform and resources
  • 30% discount to Mithrah face-to-face clinic at Parramatta, NSW, Australia upon booking, subject to availability.
  • Subsidized monthly access fees to shared space of the business across the world during business hours from Monday to Friday. We have contracts with business spaces across the world that can be accessed by all our premium members at special rates. Conditions apply.
  • Five free debriefing services a year and further services at subsidised rates. Please note that the therapists can be from overseas.
  • All services are subject to availability. There may be interruptions due to unavoidable circumstances such as natural calamities, cancellation of venues and/or office rooms due to reasons which are beyond Mithrah’s ability to control
  • Renewal needs to be done each year explicitly by the therapist. Otherwise, the standard membership plan will continue.
  • Membership can be moved from Premium to Standard if members don’t want premium services
  • Membership can be cancelled at any time upon mutual agreement

Dispute Resolution in Australia and in general

Any dispute between a therapist and a client, who receives services from the therapist, must be handled between therapist and client without involving Mithrah or the Mithrah Therapy platform.  We also encourage the therapist and client to handle disputes in a mutually amicable and beneficial way unless the disputes are related to criminal offences, and the national legal constitution must be sought to resolve the disputes. Mithrah does not provide mediation or dispute resolution services. However, we may help arrange if it is within our scope where feasible or provide guidance and direction. Mithrah Therapy Platform and Mithrah will always remain neutral and support fairness and justice.

We also recommend Australian government-recognised dispute resolution systems for all sorts of dispute resolutions such as AHPRA, HCCC and NCAT when the therapist is from Australia.

clients and therapists need to use their preferred dispute resolution strategies especially when they are not in Australia. Please note that Mithrah is a registered business in Australia. So we cannot assist with any legal or dispute services that are outside Australia and our scope

Complaint Procedures

All therapists are requested to follow the national health practitioners’ guidelines with respect to the national and state laws and constitutions. All therapists must follow their professional obligations, duties, ethics, legal requirements, social ethics, and social conduct along with international human rights obligations and national obligations of their citizenship.

Mithrah Therapy platform and Mithrah take complaint procedures seriously when there is a concern for the safety of the client and the public. We will try to resolve it as professionally possible. We may also remove some members from our service if the complaints are valid and proven.

However, we do not handle certain complaints on our own when the nature of complaint is beyond the scope of Mithrah. We may refer clients to relevant authorities and regulatory bodies regarding the complaints received when needed and/or necessary.

Contract terms and conditions

Therapists who work in Mithrah are contractors. They agree that they are not employed by Mithrah. They also agree that paying taxes in their local country according to their country of practice or where they live is fully their responsibility. Mithrah is not responsible for paying tax on behalf of the contractors who use Mithrah.

Therapists come under contractors who can choose to work their own hours. Therapists or contractors generally set their own fees unless agreed between Mithrah and the therapists and arrange their own time including work hours and holidays. The contractors work under limited or no supervision. Supervision should be the responsibility of the contractors/therapists.

The contractors must be mindful of the conflict of interest when it comes to seeing the same client at different practices. The contractors should directly or indirectly ask the client not to use Mithrah platform and refer them to some other services or their own private practice. Mithrah does not prevent clients from making their own choices in seeing any therapists wherever they want.

An employee is a person who works under an employment contract of service. Generally, he or she is required to work specific hours, for set pay, under the direction of an employer. The employment entitlements, such as wages, holiday pay, sick leave and superannuation, are the responsibility of the employer. An employee’s taxation is also the responsibility of the employer who is required to deduct tax at each pay period and provide a group certificate at the end conclusion of each financial year. Mithrah does not employ any therapists and only collaborate with contractors.

As contractors, the therapists can choose to work their own hours. The contractors will set their own fees and arrange their own time including work hours and holidays. The contractors work under limited or no supervision from Mithrah. However, they need to ensure that they take supervision from their peers or qualified therapists of their profession to provide professionally supervised therapy.

We do not restrain contractors from working anywhere unless there is a conflict of interest and this may affect the service and growth of Mithrah. The contractors should not use the resources of the Mithrah Holistic Services to build their own business.

I work at a practice three days a week as a contractor. I am provided with up to six clients per day through the practice and pay a percentage of the fees collected from the client to the principal of the practice. I am concerned with this arrangement as the APS Code of Ethics, which is binding on all psychologists under national registration, states that “

According to the regulatory standards of the counselling and psychological profession, mental health professionals such as psychiatrists, psychologists, mental health social workers and counsellors do not receive any remuneration, or give any remuneration for referring clients to, or accepting clients from, other professionals for professional services. However, Mithrah allows the contractors to see their clients who use their platforms and pays the contractors up to 90% of what our clients pay to us. Contractors/therapists who use our platform should not charge clients separately or expect any referral bonuses. Therapists who are contracted by Mithrah can provide referrals to other therapists as part of professional obligations and duty of care. Therapists agree that all payments must be made via Mithrah.

Therapists who are contracted to use the Mithrah platform agree that they agree to pay GST when relevant for using the service of the Mithrah platform which includes but is not limited to online Mithrah platform, meeting rooms, reception area, utilities, electricity, internet services, administration services, and maintenance services. Please note that the fees taken from client fees is considered as the fees taken for using the services when seeing the client. We agree to have fixed or flexible fees for seeing each client depending upon the experience, expertise or preferences of the therapists.

Matters surrounding taxation and GST are complex and it is vital that contracted therapists fully understand these issues to ensure that they are not in breach of taxation requirements.

We expect the therapists or contractors to maintain the records, case notes, and documentation regarding the clients they see. We do not maintain the case notes of the clients that was managed by the therapist when the client do not consent to the record to be shared in the system of Mithrah due to privacy and confidentiality issues.  In circumstances where contractors or therapists are working as a true subcontractors, the matter of the responsibilities for files will be managed by the subcontractor agreement. If the subcontractor agreement is silent or not direct on the question, it will be required that at the commencement of the contract or arrangement, the parties intend to follow industry customs and practices of the country they practice.

All therapists are responsible for ensuring appropriate management of their client files according to their industry and professional standards and obligations depending upon the country where they are registered to use their services.

The contractors or subcontractors should not be involved in matters or incidents which may cause dispute or disrepute to the platform.

Mithrah acknowledges that the therapists who are contractors, or sub-contractors by definition, are independent providers and can set their own fees, conduct their own billing and determine their own work hours and the platform expects the therapist to issue the invoice and bills from their end.  As per industry, therapists who provide talking therapies have an obligation to deliver a quality service to clients, and thus giving more than five or six services per day can limit the efficiency of the work. Mithrah does not promote the payment model based on a fee per client referral or based on a percentage of the therapist’s income as it may be considered unprofessional in places like Australia when the therapist is a registered practitioner of AHPRA, Australia.  Payment of contractors should therefore not be aligned to income, but to the psychologist’s usage of a consulting room and other infrastructure services. A contracted psychologist typically gives up some income in exchange for infrastructure such as renting services, infrastructure, using amenities, administration support, phone and email usage, online website services and maintenance staff for both online platforms and meeting rooms. The processing fee of the membership will cover part of the fee or using infrastructure and rest can be negotiated based on the services used.

The therapists are contractors or sub-contractors of Mithrah platforms. can stop using the services anytime they want. Otherwise, they will continue to remain as a standard membership plan even if they do not continue their premium membership plan. Unless the contractors, and sub-contractors of Mithrah explicitly inform us using our contract termination form, their names and details will be displayed.

It is possible in a true contractor/subcontractor arrangement that the principal of the practice can be held liable for the activities of the contractor. It will all depend on the circumstances of each case. Hence and However, the contractors or subcontractors and members who use our Mithrah platformsagree that they will not hold the Mithrah platform liable or accountable or responsible for any matters that arise due to their involvement.

Please note that in addition to this contract, there will be a role-specific and job-specific contract that needs to be signed which will not be posted publicly and will be only shared with those who join Mithrah.

Updating the document

The document may be updated from time to time without notice based on the change of business policies. Therapists are advised to get a copy of the updated document that will be available on the website: https://mithrah.com/therapist-service-contract-agreement/

Documents to be submitted to become a member. This may vary from country to country based on professional memebrship one holds. Basic details may include but are not limited to:

  • Attested copies of all relevant professional documents such as educational qualifications and certificates of professional memebrship
  • Statutory declaration that all submitted details are true
  • A copy of the fees that you would like to charge for your services on Mithrah. You can have a list of services and a sliding scale of payments. Please note that 10% will be taken by Mithrah as processing fees. Please note that the service fee paid by the online payment gateways will also be paid by you which is not part of the 10% processing fee.
  • A copy of your profile that can be displayed on Mithrah along with fee details.

I agree that I do not have any legal or civil cases against me that may affect my professional integrity and that may prevent me from delivering professional services to my clients in my country where I am a citizen and in any part of the world.

I agree that  I will put the safety and wellbeing of my client as my first priority when offering my services.

I agree that I will not provide any service which is beyond my qualifications and/or capacity.

I agree that I will never advise my client that I can cure any illness such as cancer, AIDS, and other terminal illnesses through my service.

I agree that I will never market other services that my clients are not signed to receive from me.

I agree that I will not charge my clients apart from what is agreed between Mithrah and me.

I agree that I will take care of any rebates or insurance from my end if my client is eligible to access them.

I agree that I will keep the privacy and confidentiality of my clients at all times unless mandatory reporting of self-harm /any harm /child abuse /child negligence/any form of violence to anyone which is illegal is involved, or subpoenaed by the court.

I agree that I will keep the documents of my clients such as consent forms, intake forms, assessment forms, and case notes of each session for 7 years or up to the duration defined by the local government of the country where I practice. If I am not sure of the duration, I will keep it for 7 years.

I agree to provide copies of relevant documents of my clients, such as case notes and assessment reports, for the services I agreed to provide when my clients request them. I also agree that I will either provide this service free of cost or at a reasonable processing cost agreed between me and my clients.

I agree that I  will follow the professional, ethical, and legal obligations of my profession with respect to the country where I practice.

I agree that the updated contract can be downloaded from time to time from the website of Mithrah by myself to keep myself updated on the professional policies of Mithrah.

I agree that I will resolve any conflicts with Mithrah in a mutually beneficial way and I agree that I will not bring any disrepute to Mithrah through my conduct.

I take the following membership with Mithrah ( tick the relevant box):

Free standard membership – $0:

Premium membership Fee – $250:

 

I agree that all information given by me is true. I agree that no refund will be given once the payment is made.

I agree to this contract.

 

Signature:

Name:

Surname:

Date:

Place