Marriage Coaching Program Registration Form

Welcome to our Marriage Coaching Program! We are dedicated to helping couples strengthen their relationship. This program is offered free of charge to residents of Raleigh and the surrounding areas, requiring a commitment to four sessions and a $100 deposit to learn the core skills for a strong marriage, refundable upon completion unless a session is missed. Please complete this form to register your interest.

Full Name (Partner 1)(Required)
Groom's or Husband's name.
Full Name (Partner 2)(Required)
Bride's or Wife's name.
Email Address(Required)
The email where you want to be contacted at.
Home Address (Must be in Raleigh or surrounding areas.)(Required)
Couple must live in or around the Raleigh area to participate.

Program Commitment

Have you attended any marriage counseling or coaching sessions before?(Required)
Otherwise, write "NA"
What areas of your relationship are you hoping to improve through this program?

Commitment and Availability

Are you able to commit to attending all four sessions of the program?(Required)
The program requires a $100 deposit as a commitment to attend ALL sessions, which is fully refundable upon completion of the program. Are you willing to comply with this requirement?(Required)
Are you willing to actively participate and complete assignments or activities given during the program?(Required)
How did you hear about this program?

Agreement

By submitting this form, you acknowledge understanding the program's requirements, including the commitment to attend all sessions and the deposit policy. You agree to engage fully and respectfully with the program to achieve the best outcomes for your relationship.

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