The Total Life Em gence - Derek Rydall...Mastermind. (Note: Personal checks are only accepted for a deposit.) • I understand that I need to pay a deposit to secure my spot in The

First Name: _____________________________________ Last Name: ____________________________________

Office Phone: ____________________________________ Home/Cell: ____________________________________

Email: ___________________________________________

Company Name: ________________________________ Website: _______________________________________

Billing Address: ___________________________________________________________________________________

City: ___________________________________ State: _________________________ Zip: ____________________

Total Payment Today: $_______________________

Payment Method: ☐MC ☐Visa ☐Amex ☐Cash ☐Check (Made to Emerging Edge Media Inc.)

Credit Card#: _________________________________ Exp: ___________________ VCode: ________________

Name on Card: ________________________________________________________

Signature: _________________________________________________ Date: _______________________________

The Total Life Emergence MASTERMIND

Create Your Soul Signature Offer, Build Your Global Platform, Launch Your Work Into the World!

YES! I want to build on the momentum of what I've uncovered at The Emergence Experience and create the structure I need to implement my vision and launch me and my brand into the world!*

Mastermind Application

YES, I wish to apply for an exclusive membership in The Total Life Emergence MASTERMIND to receive the support I need to start creating the best year of my life and stay the course NO MATTER WHAT!

!

The Total Life Emergence MASTERMIND with Derek Rydall

Please, Tell Us About You 1. What is the greatest outcome you’d like to see from your yearlong mastermind with Derek?

2. What 3 things in your business or life would you change in the next 6 months if you could?

3. Who are, or have been your major role models?

4. What were your 3 biggest accomplishments in the last two years?

5. What is your long-term vision for your life and your business?

6. What is your biggest obstacle in reaching your current goals?

7. What do you think is responsible for your current results?

8. Describe your business as it is right now:

www.DerekRydall.com Derek Rydall p. !2 [email protected]

mailto:[email protected]

http://derekrydall.com

!


9. What are you currently doing to market your business?

10. What products/services would you like to introduce in the next 12 months to reach your goals?

11. Briefly describe why YOU are a good candidate for Derek’s Total Life Emergence MASTERMIND:

12. Anything else we should know when considering you for this program?

13. Approximate gross business revenue for years indicated? (Completely confidential)

2017 (estimate): __________________________________

2016……………….: __________________________________

2015……………….: __________________________________

14. Having a list/platform is not required for success in this program, but if you have the following…

How many people on your email list? __________________________________

How many Facebook followers? __________________________________

How many Twitter followers? __________________________________

15. Please list your website, if you have one, and any other sites on which you have a presence:

Thank You For Your Application! Derek will personally review it, and we will contact you to let you know if you are approved.




!


Mastermind Levels Gold Platinum DiamondTwo Live Retreat Workshops (Value $11,000) . . .

The Emergence Academy (Value $7,000) . . .

Two Urgent Emergence Breakthrough Sessions (Value $3,000) 2, 1/2 hour Urgent Emergence Breakthrough Sessions

.

Four Sessions with Our Coaches (Value $4,000) . .

Quantum Healing Work for One Year (Value $5,000) . . .

Two In-Depth Monthly Mastermind Meetings (Value $12,000) Ongoing coaching, healing and deep dive trainings including: - The messenger maker: decode your life story to discover your hidden life’s work - Platform training: the 6 P’s that make up your platform - Creating your framework: turn your life story into your life’s work - Creating your soul’s signature offering: whether you’re an entrepreneur, artist, coach, author, healer, or executive – this puts the skin on your framework - Quantum planning: create a real plan to make this a reality - Building a global transformational business: what it really takes to make it, to endure, to become a thought leader in your field – includes training on writing books, making programs, building partnerships, etc.…

. . .

Launch & Promotional Support (Value $6,000) . . .

Private Coaching with Derek for 12 months (Value $118k-$150k) .

Retail Value $45k $48k$166k

to $198k

Normal Price $15k $18k 18+60=$78k

This Investment $11,000 $13,000 $55k




!


Special Offer! I’d like to start off my mastermind year with a deep dive foundation primer — a VIP Day with Derek at 50% off the normal price, for only $7,500! I secure my spot today with a $1,000 deposit.


Gold Please choose your payment plan: (Add 3% for Credit Card or PayPal payments.)

Option A - I secure my spot today with a $1,258 deposit, followed by 9 monthly payments of $1,258 beginning one month from today. Option B - I pay for the year in full upfront at $10,500 and save $2,080. If you select this option, secure your spot today with a $1,000 deposit, and provide the remaining balance to our team within 10 business days (check or money wire).

Diamond Please choose your payment plan: (Add 3% for Credit Card or PayPal payments.)


Platinum Please choose your payment plan: (Add 3% for Credit Card or PayPal payments.)


Level Options



!



*The Total Life Emergence Mastermind Agreement

I agree that by completing and signing this Application form I am committing to a full year of the Total Life Emergence Mastermind coaching, as indicated on the previous page. Once I am accepted into this program, I understand and commit to working with Derek in total integrity, honesty and confidentiality. • While Emerging Edge Media, Inc. guarantees the quality of the program, I understand that results will vary, depending on individual's level of commitment and engagement, therefore specific outcomes cannot be guaranteed. • I understand and agree that, by completing and signing this form, I authorize Emerging Edge Media, Inc.’s representative (team member) or Derek Rydall to charge my credit card(s) or cash my cashier’s check or personal check for the deposit at the participation rate described on the previous page, based on my selected investment option for my inclusion in the Total Life Emergence Mastermind. (Note: Personal checks are only accepted for a deposit.) • I understand that I need to pay a deposit to secure my spot in The Total Life Emergence Mastermind. This deposit is refundable within 3 business days from the date indicated below. The remaining balance is due within 10 business days from the date indicated below. • I understand that the balance of payment(s) will be made by Cashier’s Check or Wire Transfer (add $30). Credit Card or PayPal payments are for deposit only and carry a 3% processing fee. Any subsequent Credit Card payments would need to be approved. If approved client agrees to honor the payment and not to file any chargeback or dispute for the amount of payment(s). • I understand that any request for a refund “must be in writing” and emailed to: [email protected]. No other form of communication will be honored. • I understand that there are no exceptions to this refund policy. • I further understand that there are no refunds honored for anyone who has refunded previously 50% or more of their purchases. In addition there are no refunds for anyone who has filed a dispute or chargeback for any reason, for any program. • I understand that if I choose a monthly payment plan, the first full payment, less the deposit will be due within 10 ‘business’ days of the date below and subsequent payments for the balance begin one month from today and are due each 30 days thereafter until paid in full. • I understand that if I am not accepted into the program, my deposit will be refunded. • Furthermore, I agree that I am responsible for the full payment of fees for the year-long program of my choice, regardless of whether I actually attend or complete the program, and regardless of whether I have selected a lump sum or monthly payment plan. To further clarify, no refunds will be issued and all monthly payments must be paid on a timely basis and no monies collected will be refunded for any reason. If a monthly payment becomes more than 30 days late, the entire balance becomes due and payable immediately at day 31. • I understand that there are no cancellations for this program once the 3-day period has expired.

YES, please accept this application for the Total Life Emergence Mastermind and let me know if I'm accepted as soon as possible!SIGNATURE: _______________________________DATE:_____________________

(Cont)



!


For Cashier Check payments please send to: 27943 Seco Canyon Rd., #138 Santa Clarita, CA 91350

Wiring Information

Wire Routing Transit Number: 021000021

SWIFT Code: CHASUS33

Bank Name & Address: JP MORGAN/CHASE 1 Chase Manhattan, New York, NY 10005

Account Number: 3170170430

Account Name & Address: Emerging Edge Media / Derek Rydall27943 Seco Canyon, #138, Santa Clarita, CA, 91350




Documents

The Total Life Em gence - Derek Rydall...Mastermind. (Note: Personal checks are only accepted for a deposit.) • I understand that I need to pay a deposit to secure my spot in The