Practice Client Enrollment Form

This agreement is made between the "Practice Client" and the "Coach-in-Training as identified below.

The Practice Client /Coach-in-Training Relationship

The purpose of the coaching relationship is to support the Practice Client with achieving their specific goals and the Coach-in-Training with the required experience to be assessed for gaining full certification in the Erotic Blueprint™ Method, through Jaiya, Inc and its assigns or subsidiaries (hereinafter ‘The Company’).

Number of sessions and fees

The coaching delivered to you as a practice client as part of the Coach Certification Program is free. There will be a minimum total of 8 coaching sessions of 60 to 90 mins each given to you as the Practice Client. The Practice Client will receive free access to The Erotic Blueprint Breakthrough™ Course online, which the coaching sessions will be structured around. Coaching sessions will continue for 5 months beginning on the date indicated below to be held on specific dates and times as agreed between Practice Client and Coach-in-Training.

Cancellation Notice

It is asked that Practice Clients give at least 24 hours notice if they need to cancel or change the time of any session. The Coach-in-Training will make every effort to reschedule sessions in a timely manner to allow for smooth continuation of sessions.


The Coach-in-Training is responsible for fully protecting the privacy and confidentiality of the communications with their Practice Client. At no time will the Coach-in-Training voluntarily divulge the coaching relationship between themselves and their Practice Client without written permission from the Practice Client, unless required to do so by law.

Documentation Consent

Part of the certification process is the evaluation of a session between the Practice Client and the Coach-in-Training by one or several of our Erotic Blueprint Master Trainers™. Per the legitimate interest of the recorder (Coach-in-Training) to that end, at least one coaching session out of the 8 will be recorded.

The recording is strictly for the purpose of that evaluation. Only the Coach in-Training and Master Trainer Team will review the session, and it will not be stored beyond the end of the assessment period by The Company. The completion of the assessment will take place no later than January 5th of the year following the date of the submission of the recording. Recordings will be stored securely in The Company’s Dropbox account. When the recording is no longer required, it will be disposed of securely.

Recordings can be audio or video, depending on the Practice Client’s preference, and the Practice Client will be notified before the recording commences, so that the Practice Client can give consent at the time of recording. Please note your recording preference below.

Rights of Practice Client with Respect to Recorded Session(s)

Right to Access Personal Data: The Practice Client has the right to access their personal data, including recordings. If the Practice Client requests access to their personal data, including recordings, the Coach-in-Training must comply with that request within 30 days, provided the recording has not been securely disposed of after the purpose of the recording has been fulfilled.

Right to be Forgotten: The Practice Client has the right to request that their personal data, including recordings, be deleted. The Coach-in-Training must have the ability to permanently delete the recording, provided that the recording is no longer necessary to fulfill the original purpose it was intended for.

Record-Keeping Requirements

The Coach-in-Training shall be solely responsible for complying with the record-keeping requirements outlined in this Agreement, and other record-keeping requirements. The Company shall not be held responsible and shall remain blameless for a breach by Coach-in-Training in meeting these record-keeping requirements.

Data Protection Consent

In line with U.S. federal requirements and compliance laws, and in line with European requirements and compliance laws, namely the General Data Protection Regulation Act (GDPR), your consent is required for us to store data about you as we do this work together. Please read contract and, if you agree, sign below.

In the course of the provision of the services, you may disclose to us certain sensitive or other personal information about you or which may identify you (the Data). Pursuant to the provisions of the GDPR and the Data Protection Act 2018, and the Health Insurance Portability and Accountability Act of 1996 (HIPAA), you hereby explicitly consent to the control and processing of the Data in accordance with the provision of Jaiya, Inc’s Privacy Policy.

Consent Withdrawal

At any time the Practice Client may withdraw consent to continue their role as a Practice Partner Client in the Erotic Blueprint™ Coach-in-Training program.

Termination of Agreement

Either party may terminate this Agreement immediately upon notice.

Choice of Law and Venue

This Agreement and the rights of the parties hereunder shall be governed by and construed in accordance with the laws of the state of Colorado, including, but not limited to, all matters of construction, validity, performance, and enforcement and without giving effect to the principles of conflict of laws. Any action brought by any party hereto shall be brought within the courts of the state of Colorado and each party hereto agrees that personal jurisdiction exists to bring such claims. Each party shall pay its own costs and attorney fees.

Limitation of Liability


Jaiya, Inc shall not be liable for any breach of this contract on either the part of the Coach-in-Training or the Practice Client, and is not responsible for the Coach-in-Training’s transmission of this form to the Practice Client.

Severability; Entire Agreement

This contract constitutes the entire agreement between the Coach-in-Training and Practice Client. The Company and the Coach-in-Training shall not be held responsible and remain blameless for any adverse or other consequences, including but not limited to financial, personal, employment, or other losses, arising out of decisions or actions the Practice Client may make as a result of the services provided by The Company and the Coach-in-Training.

Any provision of this agreement which shall prove to be invalid, void or illegal shall in no way affect, impair or invalidate any other provision of this agreement and such other provisions shall remain in full force and effect.

Please make sure to read this entire agreement. By signing below, you agree to its terms in full, and you agree that your electronic signature is the same as a physical signature.

Your Name (Practice Client)(Required)
MM slash DD slash YYYY
Name of Coach-in-Training(Required)
MM slash DD slash YYYY
Coaching will continue for a period of 5 months from this date.