hsuchij - Did you sign anything more than this on the first day of Landmark Forum?
Here is a link to a downloadable pdf file of the Landmark Education - Forum Registration Form
[
www.landmarkeducation.com]
I have pasted the whole contents below in case it is taken off the internet.
Of note is how LE goes to great lengths to explain that:
1. It's course does not involve psychotherapy or psychological therapy, that it is education only;
2. That no one should go to seek a psychological outcome
3. That you must be psychologically healthy.
To me, point 3 contradicts the other 2.
Also, waving legal responsibility in favour of Landmark in all instances seems doubtful in a court of law.
Check out all the legal agreements at the end and the paragraph on HARASSMENT
I think that most people don't read what they are signing.
I have never seen such a document that is so far away from reality.
Oz
[b:da2a49033f]The Agreement:[/b:da2a49033f]
[b:da2a49033f]The Landmark Forum[/b:da2a49033f]• Please fill out this form completely and return it in the enclosed envelope within one week of receipt.
• The accuracy and completeness of your answers are important as a condition to your participation in this program.
We will hold the information on this form in confidence.
• Please print clearly in ink and answer every question, and please sign your name in the appropriate place.
1. The Landmark Forum (City)
Month Dates Year
2. Name (Last)
(First) (Middle)
(Name I like to be called)
3. Home Address (Street / P.O. Box)
City State Zip
4. Home Phone ( ) Work Phone ( )
5. Age Birthdate (Month/Day/Year) Sex ❍ M ❍ F
If you are under 18 years of age, you must currently live at least 50% of the time with a parent or guardian who has completed The Landmark Forum.
6. Marital Status ❍Single ❍Married ❍Widowed ❍Separated ❍Divorced ❍Domestic Partnership
7. a. Please indicate your occupation or profession:
b. What is your job title or position?
8. Have you completed The Landmark Forum? ❍ Yes ❍ No
If yes, where and when?
City Month Year
9. Name of the person who introduced you to The Landmark Forum:
10. Please list the names of all family members, relatives, friends, and business associates who are participating in The Landmark Forum with you.
Name of Person Relationship to You
(continued)
(Office Use Only)
Congratulations on having registered in The Landmark Forum. We have designed The Landmark
Forum as an opportunity for people to advance their goals and commitments, to enhance their personal
effectiveness, and to achieve consistently extraordinary results.
To help you to benefit fully from your participation in The Landmark Forum, we ask that you take a moment to state
specifically what you intend to accomplish. Answering this question does not suggest or guarantee that you will achieve
these specific results by the end of the program. However, by being specific, you will facilitate your participation. Please
print your answer in the space below. (You may attach additional pages if needed.)
11. What do you intend to accomplish?
Please read the section below carefully and completely. If you have any questions, please contact the Landmark Forum
Registration Fulfillment Manager at Landmark Education. We will assume from your participation in The Landmark Forum that
you have a full understanding of the following sections and have followed our recommendations.
The Landmark Forum is a unique course of instruction designed to support people in being more effective in realizing
their personal and societal goals. Through a series of philosophically rigorous and open discussions, voluntary sharing of
one’s own experiences, and short exercises, The Landmark Forum provides an opportunity to explore basic questions that
have been of concern to human beings throughout time. In The Landmark Forum, people come to grips with what it
means to be human—not as a mere classroom exercise, but as a rigorous inquiry. The Landmark Forum offers a unique
technology through which people create new possibilities for their lives. The power to create possibility is a natural and
authentic expression of who we are.
Although most people find inquiring into these basic questions to be engaging, challenging, and rewarding, some may
find this to be difficult and unsettling. As with any serious undertaking in life, and to achieve the maximum value from
The Landmark Forum, you should take the time now to determine whether or not you are physically, mentally, and
emotionally prepared to engage rigorously in these kinds of questions. We will assume your presence in The Landmark
Forum to indicate that you have considered the nature of The Landmark Forum and have chosen to attend on your own
responsibility, and that you are fully aware of what you are undertaking.
The Landmark Forum is intended for people who are well.
(continued)
[b:da2a49033f]Notice of Important Information[/b:da2a49033f]
The Landmark Forum (the “Program”) is an educational program. It is not therapeutic in design, intent, or methodology
and is not a substitute for medical treatment, psychotherapy, or any health program, regardless of what you may have
heard from anyone. The Program will not address issues which are best dealt with by physicians, psychotherapists, or
other health professionals.
Because some people may, contrary to everything we have stated, participate in the Program as a way of dealing
with issues that are properly addressed by health professionals, we advise you specifically that the Program Leaders are
extensively trained educators in the Landmark Education Curriculum and are not health professionals.
We further advise you that no health professionals will be in attendance at the Program.
You are responsible for your health and well-being at all times during the Program. If you have any questions about your
ability to participate in the Program, please contact the Landmark Forum Registration Fulfillment Manager at Landmark
Education. If you have not been feeling well or you have been meaning to see a physician or a mental health professional
for some complaint, symptom, or concern, we ask you to consult with your physician or mental health professional and
resolve this prior to your Program. We will provide whatever information about the Program you or your physician or
mental health professional require for you to make an informed decision.
There will be 30-minute breaks at frequent intervals—approximately every 2-1/2 to 3 hours—but we do not promise that
we will always break at precisely that interval. You are, of course, free to leave the Program at any time. Unfortunately,
any information you miss may not be repeated, and you cannot expect the same result from your participation if you are
not present for all sessions.
Each day there is one meal break in the late afternoon or early evening. We suggest that you eat a meal before arriving
at the Program, eat again during the one meal break in the day, and have a third meal or snack after you leave in the
evening. Although you may eat at other breaks in the Program if you wish, these breaks will be short.
People who have a medical condition requiring them to eat or care for some special need more frequently than the
regularly scheduled breaks, or need special seating or must stand and stretch frequently, should notify the Program
Supervisor on the morning before the start of the Program so that appropriate arrangements can be made for you.
In the Program, you will inquire into fundamental issues that have been of interest and concern to us as human
beings. In the course of such an inquiry, it is normal, from time to time, for some people to experience emotions such as
enthusiasm, excitement, compassion, sympathy, empathy, fear, anger, sadness, or regret. Some participants may find the
Program physically, mentally, and emotionally taxing. If you are unwilling to encounter any of the above experiences in
yourself or in others, or have any concern about your ability to deal with such experiences, we recommend that you not
participate in the Program at this time.
Stress is recognized by most people as a normal part of everyday living. Since different people find different events
stressful, you should assess your own participation in the Program. Health professionals have found that numerous kinds
of physical ailments may reduce a person’s tolerance to even “normal” levels of stress. We have been advised by medical
professionals that persons who have suffered physical, mental, or emotional problems may be more susceptible to stress
than others. We have also been advised by medical professionals that people who have a history of mental illness or
serious emotional problems in their immediate families may be more susceptible to stress than others.
If you or anyone in your immediate family has a history of mental illness or serious emotional problems, we recommend
that you consult with a mental health professional about your ability to handle stress. If you have any questions or
concerns about your ability to handle stress, we recommend that you do not participate in the Program.
Notice of Important Information (continued)
1. Have you ever been hospitalized for psychiatric care or a mental disorder, or has such
hospitalization ever been recommended to you by a physician, psychiatrist, or mental
health professional?
If yes, what was the MOST RECENT YEAR that you were hospitalized for psychiatric
care or a mental disorder or that such hospitalization was recommended to you by a
physician, psychiatrist, or mental health professional?
2. Are you currently in therapy?
(If you are currently in therapy, you must advise your therapist that you are going to be in the Program
and you must get your therapist’s assurance that he/she sees no health reason why it would be inadvisable
for you to take part in the Program. It is our intention here simply to serve your best interests by not
adding any input your therapist does not know about.)
(a) Have you advised your therapist that you are registered in the Program?
(b) I asked my therapist if he/she sees any health reason that would make it inadvisable for
me to participate in the Program. Mytherapist’ s answer was:
(c) I have not yet advised my therapist about being in the Program, and I will by:
(Please call the Landmark Forum Registration Fulfillment Manager at Landmark Education
as soon as you have your therapist’s answer.)
3. Have you ever been in psychiatric or psychological therapy and then discontinued that
therapy against the advice of your therapist before it was complete?
If yes, what was the MOST RECENT YEAR that you were in psychiatric or psychological
therapy and then discontinued that therapy against the advice of your therapist
before it was complete?
4. Within the past six months, have you taken (or has a health professional advised you to
take) any prescription medications or drugs which: a) affect your mental processes or mood;
or b) treat a “chemical imbalance”?
5. If you answered “yes” to questions 1 , 2b, 3, or 4, we recommend that you NOT participate
in the Program at this time. Please contact the Landmark Forum Registration Fulfillment
Manager at Landmark Education immediately regarding this recommendation. Even if you
answered “no” to questions 1, 2b, 3, or 4, you should carefully consider your participation
in the Program in terms of the long hours each day and the intensity of the work.
Please advise the Landmark Forum Registration Fulfillment Manager at Landmark
Education if, between the time you send in this form and the time your Program
begins, you experience any alteration in your health that would have your answers
to questions 1, 2, 3, or 4 change from “NO” to “YES.”
❍ YES ❍ NO
❍ YES ❍ NO
❍ YES ❍ NO
❍ YES (complete #2)
❍ NO (go to #3)
❍ YES (complete #2b)
❍ NO (go to #2c)
❍ YES, there is a health
reason that makes it inadvisable
for me to participate.
❍ NO, there is no health
reason not to participate.
Most recent year
Most recent year
Date
[b:da2a49033f]Please answer the following questions:
Agreements[/b:da2a49033f]The Agreements below and on the back page are intended to have legal significance. If you have any questions about their
meaning, please feel free to consult an attorney.
[b:da2a49033f]CONFIDENTIALITY AGREEMENT[/b:da2a49033f]
I understand that The Landmark Forum (the “Program”) is a private and personal experience for each participant. I agree to
respect the confidentiality of all participants and their remarks and actions, and I agree to keep all such information private
and confidential. I also agree not to make an audiotape or other electronic recording of all or any portion of the Program.
[b:da2a49033f]ARBITRATION AGREEMENT[/b:da2a49033f]
I agree that any controversy or claim arising out of my registration and/or my participation in the Program or any of its
associated activities, including the interpretation, execution, application, and enforcement of this Arbitration Agreement, will
be determined by submission to arbitration in accordance with the rules of the American Arbitration Association in the City
of _____________________ ,* and not by lawsuit or resort to court process, except as applicable law provides for judicial review,
confirmation and enforcement of arbitration proceedings. This Agreement includes arbitration of claims that there have
been any wrongful acts or omissions, intentional or otherwise, by Landmark Education Corporation, its officers, directors,
employees, agents, and/or volunteers. The decision of the arbitrators may be entered in any court having competent jurisdiction
of such matters. BY SIGNING THIS I AM AGREEING TO HAVE ANY ISSUE OR CLAIM ARISING OUT OF MY PARTICIPATION
IN THE LANDMARK FORUM DECIDED BY NEUTRAL ARBITRATION AND I AM FREELY GIVING UP MY
RIGHT TO A JURY OR COURT TRIAL.
*(Write in the name of the city where the Landmark Center accountable for this Program is located.)
I understand that Landmark Education Corporation is a California corporation and that this Agreement shall be construed and
governed by the laws of the State of California. This Agreement cannot be modified unless in writing and signed by both parties.
[b:da2a49033f]PROPRIETARY MATERIALS AGREEMENT[/b:da2a49033f]
I understand that all materials, concepts, and information (collectively “Materials”) presented by Landmark Education
Corporation (“Landmark”) during this Program, either orally or in writing, are the property of Landmark and are
protected by copyright, trade secret, and other applicable laws. I acknowledge that the Materials constitute commercially
valuable, proprietary, confidential property of Landmark, the design and development of which required the investment of
substantial effort, time, and money.
All rights in the Program and the Materials are expressly reserved by Landmark. I agree not to reproduce, copy, or otherwise
duplicate, and not to distribute, lend, or otherwise transfer, the Materials without the prior written permission of Landmark.
I agree not to use the Materials in any way that would compromise the confidential and proprietary nature of the Materials.
I understand that the Materials presented by Landmark in this Program are intended solely for use in the Program. I understand
that while I am free to use the Materials for my own personal use, and free to tell others about the benefits I realized
from the Program, I agree not to resell, reproduce and sell, modify and sell, or repackage and sell the Materials. I agree that
I will not use the Materials for any purpose other than my own personal use except with the prior written
permission of Landmark. I agree not to deliver the Materials themselves, either reproduced or modified, or anything derived
from the Materials, either orally or in writing, as part of any seminar, training program, workshop, consulting, or similar
business activity which I make available to my clients or to others, except with the prior written permission of Landmark.
I agree that this Agreement supersedes any prior agreements I may have regarding the use of the Materials and that, if
necessary, I will again obtain Landmark’s written permission before using any materials which I may have obtained
permission to use in the past.
(continued on back page)
Agreements (continued)
[b:da2a49033f]INFORMED CONSENT[/b:da2a49033f]
I represent and warrant that all of my responses are accurate and true.
I have read and understand all of the above Notice of Important Information as well as the Confidentiality Agreement,
Arbitration Agreement, and Proprietary Materials Agreement.
I have been informed that in order for me to receive the results of the Program, my participation must be an expression
of my own free choice.
I represent that I am participating in the Program voluntarily and not as a result of coercion, pressure, a condition of
employment, or to satisfy anyone other than myself.
I am aware and understand that some persons may perceive the Program as physically, mentally, or emotionally stressful.
I agree that Landmark Education Corporation is responsible only for the orderly presentation of the Program and that I
am responsible for my own participation in the Program and my own physical, mental, and emotional well-being.
I represent that I have not registered in the Program to handle a physical, mental, or emotional problem and I am clear
that no portion of the Program is delivered or supervised by health professionals. I know of no episodes in my past
history or that of my immediate family which suggest to me that I have a mental or emotional disorder or a recurring and
unresolved mental or emotional problem. Further, I know of no recurring symptoms, physical or mental, which suggest
to me that I may not be able to handle the types of activities described to me as part of the Program.
I promise to inform the Program Supervisor if, at any time during the Program, I experience any physical sensation or
mental or emotional discomfort which I consider to be out of the ordinary.
I willingly and knowingly assume for myself, and my heirs, family members, executors, administrators, and assigns, all risk
of physical injury and mental and emotional upset which may occur during or after the Program, and I hereby agree to
hold Landmark Education Corporation, its officers, directors, employees, agents, and/or volunteers, harmless from any
and all liability arising out of my participation in the Program.
I AGREE TO ABIDE BY THE ABOVE CONFIDENTIALITY AGREEMENT, ARBITRATION AGREEMENT, PROPRIETARY MATERIALS
AGREEMENT AND INFORMED CONSENT.
Signature Date
If you are under 18 years of age, your parent or legal guardian must read and sign below:
AS PARENT OR LEGAL GUARDIAN OF THE ABOVE-NAMED MINOR:
1. I HAVE COMPLETED THE LANDMARK FORUM AND THE ABOVE-NAMED MINOR LIVES WITH ME AT LEAST 50% OF THE TIME.
2. I GIVE MY PERMISSION FOR MY CHILD TO TAKE THE LANDMARK FORUM.
3. I AGREE TO THE ABOVE CONFIDENTIALITY AGREEMENT, ARBITRATION AGREEMENT, PROPRIETARY MATERIALS AGREEMENT, AND INFORMED
CONSENT ON HIS/HER BEHALF.
Parent’s Signature Date
[b:da2a49033f]SEXUAL HARASSMENT POLICY[/b:da2a49033f]
Landmark is committed to providing an environment free from sexual or other forms of harassment. Any harassment is
unlawful and will not be tolerated by Landmark. If you believe you have been unlawfully harassed, you should contact the
Local Center Manager, or the Director of Human Resources at Landmark’s World Headquarters in San Francisco
(at 415-616-2401). If you have any questions about Landmark’s Sexual Harassment Policy or would like a copy of the
Policy, please contact either of these people.
www.landmarkeducation.com
© 2001 Landmark Education Corporation
024-501