{"id":90,"date":"2023-09-28T16:37:47","date_gmt":"2023-09-28T16:37:47","guid":{"rendered":"https:\/\/energy-rejuvenation.com\/?page_id=90"},"modified":"2024-02-12T18:18:12","modified_gmt":"2024-02-12T18:18:12","slug":"membership","status":"publish","type":"page","link":"https:\/\/energy-rejuvenation.com\/?page_id=90","title":{"rendered":"Membership"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; fullwidth=&#8221;on&#8221; next_background_color=&#8221;#ffffff&#8221; _builder_version=&#8221;4.22.2&#8243; _module_preset=&#8221;default&#8221; background_color=&#8221;rgba(51,6,6,0)&#8221; use_background_color_gradient=&#8221;on&#8221; background_color_gradient_direction=&#8221;275deg&#8221; background_color_gradient_stops=&#8221;rgba(153,210,255,0) 33%|rgba(10,10,10,0.86) 100%&#8221; background_color_gradient_start=&#8221;rgba(153,210,255,0)&#8221; background_color_gradient_start_position=&#8221;16%&#8221; background_color_gradient_end=&#8221;#0f9bff&#8221; background_color_gradient_end_position=&#8221;84%&#8221; background_image=&#8221;https:\/\/energy-rejuvenation.com\/wp-content\/uploads\/2023\/09\/243.jpg&#8221; min_height=&#8221;429px&#8221; custom_padding=&#8221;||0px|||&#8221; bottom_divider_style=&#8221;waves2&#8243; bottom_divider_height=&#8221;49px&#8221; bottom_divider_repeat=&#8221;1x&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_fullwidth_header title=&#8221;Membership&#8221; text_orientation=&#8221;center&#8221; background_overlay_color=&#8221;rgba(0,0,0,0.53)&#8221; _builder_version=&#8221;4.22.2&#8243; _module_preset=&#8221;default&#8221; background_enable_color=&#8221;off&#8221; custom_padding=&#8221;||180px|||&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p>A Private Member Association.<\/p>\n<p>We look forward to welcoming you to our unique wellness community.<\/p>\n<p>[\/et_pb_fullwidth_header][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; custom_padding_last_edited=&#8221;on|phone&#8221; admin_label=&#8221;About&#8221; _builder_version=&#8221;4.22.2&#8243; _module_preset=&#8221;default&#8221; use_background_color_gradient=&#8221;on&#8221; background_color_gradient_type=&#8221;elliptical&#8221; background_color_gradient_stops=&#8221;rgba(255,255,255,0.82) 0%|#ffffff 74%|#ffffff 92%&#8221; background_color_gradient_overlays_image=&#8221;on&#8221; background_image=&#8221;https:\/\/energy-rejuvenation.com\/wp-content\/uploads\/2023\/09\/Modern-Abstract-Backgrounds-Vol.-02-2-scaled.jpg&#8221; custom_margin=&#8221;1px|||||&#8221; custom_padding=&#8221;0px||0px|||&#8221; custom_padding_tablet=&#8221;0px||||false|false&#8221; custom_padding_phone=&#8221;0px||||false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.22.2&#8243; _module_preset=&#8221;default&#8221; background_enable_image=&#8221;off&#8221; custom_padding=&#8221;36px|||||&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.22.2&#8243; _module_preset=&#8221;003e9429-8e11-4d9e-968b-8881092bbf81&#8243; header_2_font=&#8221;|700|||||||&#8221; header_2_text_color=&#8221;#000000&#8243; header_2_font_size=&#8221;60px&#8221; header_2_line_height=&#8221;1.1em&#8221; text_orientation=&#8221;center&#8221; header_2_font_size_tablet=&#8221;32px&#8221; header_2_font_size_phone=&#8221;20px&#8221; header_2_font_size_last_edited=&#8221;on|phone&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h2>Membership Agreement<\/h2>\n<p>&nbsp;<\/p>\n<p>Kindly note that a fee of $20.00 is the cost of membership to be paid upon arrival for your first session or before.\u00a0 You can also book online. Thank you.<\/p>\n<p>&nbsp;<\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=&#8221;4.22.2&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.22.2&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.22.2&#8243; _module_preset=&#8221;default&#8221; background_color=&#8221;#FFFFFF&#8221; custom_padding=&#8221;18px|33px|18px|33px|true|true&#8221; box_shadow_style=&#8221;preset3&#8243; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p><span><script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar 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Form<\/h2>\n                            <p class='gform_description'>Energy Rejuvenation Wellness Center Member Application Form<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_2'  action='\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F90' data-formid='2' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_2_1\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_2_1'>\n                            \n                            <span id='input_2_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_2_1_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_2_1_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_2_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_2_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_2_1_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_2_3\" class=\"gfield gfield--type-phone gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_3'>Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_3' id='input_2_3' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_2_4\" class=\"gfield gfield--type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_4'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_4' id='input_2_4' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_2_5\" class=\"gfield gfield--type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_5'>Notes (optional)<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_5' id='input_2_5' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_2_6\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Equipment:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_6'><div class='gchoice gchoice_2_6_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_6.1' type='checkbox'  value='I am aware the EESystem is installed with precision that requires a trained installer to fly into town to recalibrate. I will not touch the equipment, or the shelves the equipment is on, and agree to be responsible if I cause the equipment to be moved in any way. I understand I will be charged $2000 if I do, whether intentionally or accidentally.'  id='choice_2_6_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_6_1' id='label_2_6_1' class='gform-field-label gform-field-label--type-inline'>I am aware the EESystem is installed with precision that requires a trained installer to fly into town to recalibrate. I will not touch the equipment, or the shelves the equipment is on, and agree to be responsible if I cause the equipment to be moved in any way. I understand I will be charged $2000 if I do, whether intentionally or accidentally.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_7\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Detoxification Symptoms:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_7'><div class='gchoice gchoice_2_7_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.1' type='checkbox'  value='I am aware that I may experience detoxification symptoms. I take full responsibility for drinking more water, before during and, at least, for a week after each session, taking sea salt baths within 24hrs of a session and ideally 2-3 times a week, and\/or other measures needed to facilitate the elimination of toxins as recommended by Agape In Practice, a PMA through its projects, as well as replenishing minerals including, but not limited to magnesium, potassium, manganese, zine, etc. as they will have been drawn out along with the toxins.'  id='choice_2_7_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_7_1' id='label_2_7_1' class='gform-field-label gform-field-label--type-inline'>I am aware that I may experience detoxification symptoms. I take full responsibility for drinking more water, before during and, at least, for a week after each session, taking sea salt baths within 24hrs of a session and ideally 2-3 times a week, and\/or other measures needed to facilitate the elimination of toxins as recommended by Agape In Practice, a PMA through its projects, as well as replenishing minerals including, but not limited to magnesium, potassium, manganese, zine, etc. as they will have been drawn out along with the toxins.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_8\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Diabetics &amp; Others on Medications:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_8'><div class='gchoice gchoice_2_8_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_8.1' type='checkbox'  value='It is important to monitor your condition. Diabetics, monitor your blood sugar as your body may require less insulin once it responds to the energy fields created by the EESystem\u2122 Technology. The same may apply to those on blood pressure medication and any other conditions you may be taking medication for. HENCE, I understand it\u2019s my responsibility to monitor myself, be mindful of any changes that may take place that might affect the need to decrease dosages and to consult my physician before doing so.'  id='choice_2_8_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_8_1' id='label_2_8_1' class='gform-field-label gform-field-label--type-inline'>It is important to monitor your condition. Diabetics, monitor your blood sugar as your body may require less insulin once it responds to the energy fields created by the EESystem\u2122 Technology. The same may apply to those on blood pressure medication and any other conditions you may be taking medication for. HENCE, I understand it\u2019s my responsibility to monitor myself, be mindful of any changes that may take place that might affect the need to decrease dosages and to consult my physician before doing so.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_9\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Recording:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_9'><div class='gchoice gchoice_2_9_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.1' type='checkbox'  value='I agree to the recording of my experiences in connection with research, education, and promotion of the EESystem\u2122 Technology and\/or by any projects under Energy Rejuvenation Wellness Society.  Energy Rejuvenation will be the owner of all rights in, and to, my experience with the EESystem\u2122 Technology in video, written or spoken form for he above purposes.'  id='choice_2_9_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_9_1' id='label_2_9_1' class='gform-field-label gform-field-label--type-inline'>I agree to the recording of my experiences in connection with research, education, and promotion of the EESystem\u2122 Technology and\/or by any projects under Energy Rejuvenation Wellness Society.  Energy Rejuvenation will be the owner of all rights in, and to, my experience with the EESystem\u2122 Technology in video, written or spoken form for he above purposes.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_11\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Comfortable:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_11'><div class='gchoice gchoice_2_11_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.1' type='checkbox'  value='I understand I need to bring what I\u2019ll need to make myself comfortable including a spill proof water bottle to refill as needed, pillow, blanket, sheet, eye mask, ear plugs (in case others snore) and that if I forget anything, I\u2019ll need to retrieve it within 10 days, otherwise it will be disposed of. I\u2019ll also come with an open, receptive mind, A heartfelt emotionally charged intention and the conviction to do my part while my body does its thing.'  id='choice_2_11_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_11_1' id='label_2_11_1' class='gform-field-label gform-field-label--type-inline'>I understand I need to bring what I\u2019ll need to make myself comfortable including a spill proof water bottle to refill as needed, pillow, blanket, sheet, eye mask, ear plugs (in case others snore) and that if I forget anything, I\u2019ll need to retrieve it within 10 days, otherwise it will be disposed of. I\u2019ll also come with an open, receptive mind, A heartfelt emotionally charged intention and the conviction to do my part while my body does its thing.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_14\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Our Energy Enhancement System { EES} facility combines body, mind, spirit, and science to help achieve peak performance, reach high states of consciousness, human development, and psychological well being.\n\nAt Energy Rejuvenation Wellness Center, we do not dispense medical advice, prescribe, or diagnose illness.  The views and  advice of  EES  are not intended to be a substitute for conventional medical advice or service.  If you have a severe medical condition or health concern see your physician.\n\nResults may vary. Information and statements are for educational purposes only, and are not intended to replace the advice of your doctor.<\/div><div id=\"field_2_13\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Please read the Energy Rejuvenation Terms & Conditions. and our Policies & Procedures. By checking the box you agree to the Membership agreement and Policies & Procedures.\nYou will receive a confirmation email from info@energy-rejuvenation.com. If you don't receive an email in your inbox, please check your spam\/junk folder and mark the email as \"Not Spam\".<\/div><fieldset id=\"field_2_10\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >I read and agree to the Energy Rejuvenation Wellness Terms &amp; Conditions and the Policies &amp; Procedures *<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_10'><div class='gchoice gchoice_2_10_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.1' type='checkbox'  value='I have read, and agree to the website terms and conditions.'  id='choice_2_10_1'   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field_type=&#8221;text&#8221; fullwidth_field=&#8221;on&#8221; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221; button_text_size__hover_enabled=&#8221;off&#8221; button_one_text_size__hover_enabled=&#8221;off&#8221; button_two_text_size__hover_enabled=&#8221;off&#8221; button_text_color__hover_enabled=&#8221;off&#8221; button_one_text_color__hover_enabled=&#8221;off&#8221; button_two_text_color__hover_enabled=&#8221;off&#8221; button_border_width__hover_enabled=&#8221;off&#8221; button_one_border_width__hover_enabled=&#8221;off&#8221; button_two_border_width__hover_enabled=&#8221;off&#8221; button_border_color__hover_enabled=&#8221;off&#8221; button_one_border_color__hover_enabled=&#8221;off&#8221; button_two_border_color__hover_enabled=&#8221;off&#8221; button_border_radius__hover_enabled=&#8221;off&#8221; button_one_border_radius__hover_enabled=&#8221;off&#8221; button_two_border_radius__hover_enabled=&#8221;off&#8221; button_letter_spacing__hover_enabled=&#8221;off&#8221; button_one_letter_spacing__hover_enabled=&#8221;off&#8221; button_two_letter_spacing__hover_enabled=&#8221;off&#8221; button_bg_color__hover_enabled=&#8221;off&#8221; button_one_bg_color__hover_enabled=&#8221;off&#8221; button_two_bg_color__hover_enabled=&#8221;off&#8221;][\/et_pb_contact_field][\/et_pb_contact_form][\/et_pb_column][et_pb_column type=&#8221;1_2&#8243; _builder_version=&#8221;4.22.2&#8243; _module_preset=&#8221;default&#8221; background_color=&#8221;rgba(160,100,244,0.71)&#8221; transform_scale_tablet=&#8221;&#8221; transform_scale_phone=&#8221;&#8221; transform_scale_last_edited=&#8221;on|tablet&#8221; transform_translate=&#8221;0px|-80px&#8221; transform_translate_tablet=&#8221;0px|0px&#8221; transform_translate_phone=&#8221;&#8221; transform_translate_last_edited=&#8221;on|tablet&#8221; transform_translate_linked=&#8221;off&#8221; transform_rotate_tablet=&#8221;&#8221; transform_rotate_phone=&#8221;&#8221; transform_rotate_last_edited=&#8221;on|tablet&#8221; transform_skew_tablet=&#8221;&#8221; transform_skew_phone=&#8221;&#8221; transform_skew_last_edited=&#8221;on|tablet&#8221; transform_origin_tablet=&#8221;&#8221; transform_origin_phone=&#8221;&#8221; transform_origin_last_edited=&#8221;on|tablet&#8221; transform_styles_last_edited=&#8221;on|tablet&#8221; z_index=&#8221;500&#8243; custom_padding=&#8221;40px|40px|40px|40px|true|true&#8221; custom_padding_tablet=&#8221;30px|30px|30px|30px|true|true&#8221; custom_padding_phone=&#8221;20px|20px|20px|20px|true|true&#8221; custom_padding_last_edited=&#8221;on|phone&#8221; transform_styles_tablet=&#8221;&#8221; transform_styles_phone=&#8221;&#8221; border_radii=&#8221;off|||30px|30px&#8221; border_radii_tablet=&#8221;off|30px|30px|30px|30px&#8221; border_radii_phone=&#8221;off|30px|30px|30px|30px&#8221; border_radii_last_edited=&#8221;on|phone&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;0c6bc8be-1265-496d-a8dc-bc5e9a9a9edf&#8221; header_font=&#8221;||||||||&#8221; header_3_font=&#8221;Jost|700|||||||&#8221; header_3_text_color=&#8221;#FFFFFF&#8221; header_3_font_size=&#8221;40px&#8221; header_3_line_height=&#8221;1.2em&#8221; header_3_font_size_tablet=&#8221;20px&#8221; header_3_font_size_phone=&#8221;16px&#8221; header_3_font_size_last_edited=&#8221;on|phone&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h3>Become a Member<\/h3>\n<p>[\/et_pb_text][et_pb_text _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;22d0da71-6393-430b-a0cd-b77dd565e85c&#8221; text_text_color=&#8221;#FFFFFF&#8221; text_line_height=&#8221;1.8em&#8221; text_font_size_tablet=&#8221;15px&#8221; text_font_size_phone=&#8221;14px&#8221; text_font_size_last_edited=&#8221;on|phone&#8221; header_font_size_tablet=&#8221;55px&#8221; header_font_size_last_edited=&#8221;off|desktop&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p>Energy Rejuvenation Wellness Center is a Private Member Association.\u00a0We look forward to welcoming you to our unique wellness community.<\/p>\n<p>[\/et_pb_text][et_pb_button button_url=&#8221;@ET-DC@eyJkeW5hbWljIjp0cnVlLCJjb250ZW50IjoicG9zdF9saW5rX3VybF9wYWdlIiwic2V0dGluZ3MiOnsicG9zdF9pZCI6IjkwIn19@&#8221; button_text=&#8221;Membership Application&#8221; _builder_version=&#8221;4.22.2&#8243; _dynamic_attributes=&#8221;button_url&#8221; _module_preset=&#8221;default&#8221; custom_button=&#8221;on&#8221; button_text_color=&#8221;#8300E9&#8243; button_bg_color=&#8221;#FFFFFF&#8221; button_border_color=&#8221;#FFFFFF&#8221; global_colors_info=&#8221;{}&#8221;][\/et_pb_button][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=&#8221;1_4,3_4&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;1_4&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.22.2&#8243; _module_preset=&#8221;38128ce4-78a8-4c45-b3ff-f4fb37f074f0&#8243; header_font=&#8221;||||||||&#8221; header_4_font=&#8221;Jost|700|||||||&#8221; header_4_text_color=&#8221;#FFFFFF&#8221; header_4_font_size=&#8221;28px&#8221; header_4_line_height=&#8221;1.3em&#8221; custom_margin=&#8221;||10px||false|false&#8221; header_4_font_size_tablet=&#8221;16px&#8221; header_4_font_size_phone=&#8221;14px&#8221; header_4_font_size_last_edited=&#8221;on|tablet&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h4>Phone<\/h4>\n<p>[\/et_pb_text][et_pb_text _builder_version=&#8221;4.22.2&#8243; _module_preset=&#8221;22d0da71-6393-430b-a0cd-b77dd565e85c&#8221; text_text_color=&#8221;#C9D4DA&#8221; text_line_height=&#8221;1.8em&#8221; text_font_size_tablet=&#8221;15px&#8221; text_font_size_phone=&#8221;14px&#8221; text_font_size_last_edited=&#8221;on|phone&#8221; header_font_size_tablet=&#8221;55px&#8221; header_font_size_last_edited=&#8221;off|desktop&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p>(352) 640-2529<\/p>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;3_4&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.22.2&#8243; _module_preset=&#8221;38128ce4-78a8-4c45-b3ff-f4fb37f074f0&#8243; header_font=&#8221;||||||||&#8221; header_4_font=&#8221;Jost|700|||||||&#8221; header_4_text_color=&#8221;#FFFFFF&#8221; header_4_line_height=&#8221;1.3em&#8221; custom_margin=&#8221;||10px||false|false&#8221; header_4_font_size_tablet=&#8221;16px&#8221; header_4_font_size_phone=&#8221;14px&#8221; header_4_font_size_last_edited=&#8221;on|tablet&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h4>Address<\/h4>\n<p>[\/et_pb_text][et_pb_text _builder_version=&#8221;4.22.2&#8243; _module_preset=&#8221;22d0da71-6393-430b-a0cd-b77dd565e85c&#8221; text_text_color=&#8221;#C9D4DA&#8221; text_line_height=&#8221;1.8em&#8221; text_font_size_tablet=&#8221;15px&#8221; text_font_size_phone=&#8221;14px&#8221; text_font_size_last_edited=&#8221;on|phone&#8221; header_font_size_tablet=&#8221;55px&#8221; header_font_size_last_edited=&#8221;off|desktop&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p>10935 SE 177th Place\u00a0 Suite 506-507\u00a0 Summerfield, Florida 34491<\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=&#8221;4.22.2&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.22.2&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.22.2&#8243; _module_preset=&#8221;default&#8221; text_font=&#8221;|300|||||||&#8221; text_font_size=&#8221;14px&#8221; text_line_height=&#8221;1.4em&#8221; background_layout=&#8221;dark&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h4><span>Disclaimer<\/span><\/h4>\n<p><span>The statements on this website are intended for educational purposes only and have not been evaluated or approved by the Food and Drug Administration.\u00a0 They are not intended to replace the advice and care from your licensed Medical or Health Care Practitioner.\u00a0 We make no claims to heal, cure, treat, mitigate, or prevent any illness or disease.\u00a0 No nutritional formula or Vibrational\/Energy Medicine Therapy or Device can heal or cure anything. They serve to support the body&#8217;s own Innate Intelligence in strengthening the body&#8217;s vital energies and defense mechanisms toward achieving a state of balance. <\/span><\/p>\n<p><span>Energy Rejuvneation Wellness Center is a project of the Energy Rejuvenation Wellness Society.<\/span><\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>A Private Member Association. We look forward to welcoming you to our unique wellness community.Membership Agreement &nbsp; Kindly note that a fee of $20.00 is the cost of membership to be paid upon arrival for your first session or before.\u00a0 You can also book online. Thank you. &nbsp;\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_2' >\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Energy Rejuvenation Wellness Society New Membership Application Form<\/h2>\n                            <p class='gform_description'>Energy Rejuvenation Wellness Center Member Application Form<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_2'  action='\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F90' data-formid='2' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_2_1\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_2_1'>\n                            \n                            <span id='input_2_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_2_1_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_2_1_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_2_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_2_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_2_1_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_2_3\" class=\"gfield gfield--type-phone gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_3'>Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_3' id='input_2_3' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_2_4\" class=\"gfield gfield--type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_4'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_4' id='input_2_4' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_2_5\" class=\"gfield gfield--type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_5'>Notes (optional)<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_5' id='input_2_5' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_2_6\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Equipment:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_6'><div class='gchoice gchoice_2_6_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_6.1' type='checkbox'  value='I am aware the EESystem is installed with precision that requires a trained installer to fly into town to recalibrate. I will not touch the equipment, or the shelves the equipment is on, and agree to be responsible if I cause the equipment to be moved in any way. I understand I will be charged $2000 if I do, whether intentionally or accidentally.'  id='choice_2_6_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_6_1' id='label_2_6_1' class='gform-field-label gform-field-label--type-inline'>I am aware the EESystem is installed with precision that requires a trained installer to fly into town to recalibrate. I will not touch the equipment, or the shelves the equipment is on, and agree to be responsible if I cause the equipment to be moved in any way. I understand I will be charged $2000 if I do, whether intentionally or accidentally.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_7\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Detoxification Symptoms:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_7'><div class='gchoice gchoice_2_7_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.1' type='checkbox'  value='I am aware that I may experience detoxification symptoms. I take full responsibility for drinking more water, before during and, at least, for a week after each session, taking sea salt baths within 24hrs of a session and ideally 2-3 times a week, and\/or other measures needed to facilitate the elimination of toxins as recommended by Agape In Practice, a PMA through its projects, as well as replenishing minerals including, but not limited to magnesium, potassium, manganese, zine, etc. as they will have been drawn out along with the toxins.'  id='choice_2_7_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_7_1' id='label_2_7_1' class='gform-field-label gform-field-label--type-inline'>I am aware that I may experience detoxification symptoms. I take full responsibility for drinking more water, before during and, at least, for a week after each session, taking sea salt baths within 24hrs of a session and ideally 2-3 times a week, and\/or other measures needed to facilitate the elimination of toxins as recommended by Agape In Practice, a PMA through its projects, as well as replenishing minerals including, but not limited to magnesium, potassium, manganese, zine, etc. as they will have been drawn out along with the toxins.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_8\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Diabetics &amp; Others on Medications:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_8'><div class='gchoice gchoice_2_8_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_8.1' type='checkbox'  value='It is important to monitor your condition. Diabetics, monitor your blood sugar as your body may require less insulin once it responds to the energy fields created by the EESystem\u2122 Technology. The same may apply to those on blood pressure medication and any other conditions you may be taking medication for. HENCE, I understand it\u2019s my responsibility to monitor myself, be mindful of any changes that may take place that might affect the need to decrease dosages and to consult my physician before doing so.'  id='choice_2_8_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_8_1' id='label_2_8_1' class='gform-field-label gform-field-label--type-inline'>It is important to monitor your condition. Diabetics, monitor your blood sugar as your body may require less insulin once it responds to the energy fields created by the EESystem\u2122 Technology. The same may apply to those on blood pressure medication and any other conditions you may be taking medication for. HENCE, I understand it\u2019s my responsibility to monitor myself, be mindful of any changes that may take place that might affect the need to decrease dosages and to consult my physician before doing so.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_9\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Recording:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_9'><div class='gchoice gchoice_2_9_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.1' type='checkbox'  value='I agree to the recording of my experiences in connection with research, education, and promotion of the EESystem\u2122 Technology and\/or by any projects under Energy Rejuvenation Wellness Society.  Energy Rejuvenation will be the owner of all rights in, and to, my experience with the EESystem\u2122 Technology in video, written or spoken form for he above purposes.'  id='choice_2_9_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_9_1' id='label_2_9_1' class='gform-field-label gform-field-label--type-inline'>I agree to the recording of my experiences in connection with research, education, and promotion of the EESystem\u2122 Technology and\/or by any projects under Energy Rejuvenation Wellness Society.  Energy Rejuvenation will be the owner of all rights in, and to, my experience with the EESystem\u2122 Technology in video, written or spoken form for he above purposes.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_11\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Comfortable:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_11'><div class='gchoice gchoice_2_11_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.1' type='checkbox'  value='I understand I need to bring what I\u2019ll need to make myself comfortable including a spill proof water bottle to refill as needed, pillow, blanket, sheet, eye mask, ear plugs (in case others snore) and that if I forget anything, I\u2019ll need to retrieve it within 10 days, otherwise it will be disposed of. I\u2019ll also come with an open, receptive mind, A heartfelt emotionally charged intention and the conviction to do my part while my body does its thing.'  id='choice_2_11_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_11_1' id='label_2_11_1' class='gform-field-label gform-field-label--type-inline'>I understand I need to bring what I\u2019ll need to make myself comfortable including a spill proof water bottle to refill as needed, pillow, blanket, sheet, eye mask, ear plugs (in case others snore) and that if I forget anything, I\u2019ll need to retrieve it within 10 days, otherwise it will be disposed of. I\u2019ll also come with an open, receptive mind, A heartfelt emotionally charged intention and the conviction to do my part while my body does its thing.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_14\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Our Energy Enhancement System { EES} facility combines body, mind, spirit, and science to help achieve peak performance, reach high states of consciousness, human development, and psychological well being.\n\nAt Energy Rejuvenation Wellness Center, we do not dispense medical advice, prescribe, or diagnose illness.  The views and  advice of  EES  are not intended to be a substitute for conventional medical advice or service.  If you have a severe medical condition or health concern see your physician.\n\nResults may vary. 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