Pre-Enrollment Application & Payment Acknowledgment

Please complete this form if you are enrolling in one of the following courses: Lymphatic Detox Plus Therapy (MLD) 2-Day Certification, Surgical Lymphatic Method 3-Day Certification, and Facial Bio-Sculpting 1-Day Certification.

Personal Information:

Email (Use the same address that is on record with Sculpture Academy) *

Full Legal Name *

Date of Birth *

Address *

Street Address

City

State

Country

Postal Code

Professional Experience:

Years of Professional Experience

License or Certification (If applicable)

License Number & State/Country

Previous Education:

Do you have previous lymphatic training? *

Yes

If "Yes" where did you receive this training?

Course Intent:

Why do you want to take this course? *

How do you plan to use this training? *

Clinical

Aesthetic

Post-Op

Personal

Health Disclosure (Confidential):

Is any condition limiting your hands-on work? *

Yes

If "Yes" please explain

Are you pregnant? *

Yes

Course Acknowledgements:

Acknowledge the following declarations *

I understand this is an intensive educational certification

I understand approval is required before enrollment

I agree to attend 100% of course hours

I acknowledge that a separate Liability Waiver must be signed prior to participation

Please indicate which course and session you plan to attend by checking the box *

June 27-28 (2 Days): Lymphatic Detox Plus Therapy

July 11 (1 Day): Facial Bio-Sculpting

August 29-30 (2 Days): Lymphatic Detox Plus Therapy

September 26-28 (3 Days): Surgical Lymphatic Method

October 24-25 (2 Days): Lymphatic Detox Plus Therapy

November 21-23 (3 Days): Surgical Lymphatic Method

Payment Information:

Facial Bio-Sculpting 1-Day Certification is $1200. To reserve your seat in your selected course, a minimum deposit of $650 is required.

Lymphatic Detox Plus Therapy 2-Day Certification is $2,990. To reserve your seat in your selected course, a minimum deposit of $950 is required.

Surgical Lymphatic Method 3-Day Certification is $3,590. To reserve your seat in your selected course, a minimum deposit of $1100 is required.

Please choose your preferred payment amount and method below. Once your enrollment is approved, we’ll follow up with the next steps to complete your payment.

Choose Payment Method *

Credit Card (Processing fee applies)

Venmo/Zelle

Financing (Approval required)

Acknowledgement of payment in full *

I understand my seat is not reserved or guaranteed until full payment is received and confirmed

Acknowledgement of payment due date *

I understand that full payment is due no later than 10 days before the course start state

Cancellation & Refund Policy:

· Deposits are refundable only within 7 calendar days of payment and become non-refundable thereafter.

· All other payments made toward this course are non-refundable.

· Cancellations for any reason, including personal, medical, scheduling conflicts, or last-minute cancellations, do not qualify for a refund.

· Due to advanced planning, travel, and reserved class space, no exceptions will be made to this policy.

· By signing below, you acknowledge and agree to this policy.

Sign here *

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Date signed (Today's date) *

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