Awakening Your Light Body
Enrollment Questionnaire

We are looking forward to meeting you and want to do all we can to assist you in getting as much as possible out of these courses. Your answers to this questionnaire will allow us to give you better, more individualized assistance. They can also be useful to you later as a reference point to highlight your progress.
You may want to photocopy this questionnaire and use it as a starting point for your Light Body journal. There are no right or wrong answers. Feel free to attach extra sheets if you need more room. Tell us anything about yourself you would like us to know. All information is confidential.

Please print clearly and return as soon as possible with your $250 deposit.

Thank you.

___I am enrolling in the Awakening Your Light Body course beginning ___________________(date).

___I am responding by at least 2 weeks early. Please notify me of any current bonus incentives for early enrollment.

Make check payable to Ray Hix.

Name:

Street Address:

City:

State:

Zip:

Daytime phone:

Evening phone:

Birthdate:

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1. What results would you like to produce for yourself out of your participation in the seminar? What breakthroughs do you feel you are up to having now? What commitments of yours would you most like to have empowered through this work? (Use an extra sheet if necessary.)

2. Are you open to feedback and coaching that may reveal aspects of yourself you either haven't been aware of, or have been avoiding? (We are committed that any coaching we deliver specific to you is made from love, in love, valuing you as you are. And any invitation to go higher is simply that: a n invitation. It's OK to decline the invitation. We do ask that if you choose to decline our coaching, you decline it in love.)

3. Do the people around you support your spiritual growth? Do you have others you can talk to about spiritual experiences or friends who have a similar belief system?

4. Do you channel a guide, your soul, or both? Are you interested in learning how to achieve a deeper, clearer connection for channeling?

5. Tell us anything about your spiritual growth background you'd like us to know -- trainings, courses, techniques or books that were important to you, your experience with expanded states of consciousness (meditation, self-hypnosis, guided meditations, trance states), or whatever is making a diff erence your life.

6. Do you believe you create your own reality? Are you willing to know yourself as the source of your experience? Do you take responsibility for your experience? Do you communicate responsibly when you are upset or reactivated?

7. Are you at a point in your life where you can devote at least half an hour a day to your spiritual growth?

8. Have you ever been hospitalized for psychiatric care or a mental disorder? Have you in the past or are you currently in therapy for or have any major mental/psychiatric disorders? If yes, please describe:

9. Tell us anything else about yourself you'd like us to know. (Attach an extra sheet if necessary.)

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Please read and sign the waiver below:

We will be using many exploratory, expanded states of consciousness during this course to assist you in awakening your Light Body. These techniques include guided meditations and energy awareness techniques. Some of the states of consciousness, self-examination and personal insights can be ver y stimulating, exciting, or create emotional releases. Using these techniques will put you on a path of accelerated spiritual growth, which can create emotional, physical, and mental changes.

While the techniques and energies we'll be working with are themselves very safe, they tend to facilitate breakthroughs in people's lives. Whenever you commit to a breakthrough in any area, you can expect to come up against whatever it is that's been keeping you from that breakthrough up until no w. That sometimes looks and feels like breakdown. These energies themselves will not bring you any problem, symptom, or condition that you would not have eventually encountered on your own. However, you may experience an acceleration of the rate at which your lessons appear in your life, and the rate with which you work through and resolve them.

If you have a mental or physical condition that would make participation unwise in light of this knowledge, we advise you to reconsider participation at this time. Please realize this course is not psychotherapeutic in nature. We know of no case or have any knowledge of any case on record where a n individual has ever been harmed by attending one of our seminars. We do know of hundreds of cases where people have benefited in many ways from using these techniques. It is necessary as a general practice to have everyone taking part in the courses sign the waiver.

Waiver: I have read and understood the above. I am of legal age, and in consideration of my participation in Ray Hix's Awakening Your Light Body course, I for myself, my executors, administrators and assignees, do hereby release and discharge Ray Hix and any of his employees, assistants, co unselors, or support team, for all claims of damages, demands, actions, whatsoever in any manner arising from or growing out of my participation in the course.

Signature__________________________________

Age________

Date_________________

Thank you for taking the time to fill this out. I look forward to our time together.

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A note about payment:

We can't yet accept credit cards, so you will need to mail us a check. (Make checks payable to Ray Hix.) You can copy this form to your editor, fill it out, and email it to me, or print it out and mail it with your check.

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To return to the Flyer:

Awakening Your Light Body Flyer.

To return to the Brochure:

Awakening Your Light Body Brochure.

You can email Ray at:

Or Phone Ray at:

(510) 525-7470