Please fill out this form until the
“thank you” page
TO CONFIRM your 1-on-1 training session.

Your session will be confirmed AFTER these forms are completed.

Fill in these forms to register with your trainer:

Connexions Training

1400 Chapel Street. PO Box 782
Santa Clara, UT 84765
(801) 874-7691

  • AUTHORIZATION OF RELEASE OF INFORMATION

  • I,
  • whose birthdate is
  • MM slash DD slash YYYY
  • hereby authorize my Connexions Trainer and/or Connexions Training staff to:

  • It is requested that the following specific information be provided:

    YOU MUST INITIAL THE LINES BELOW.

  • In consideration of this consent, I hereby release Jodi Hildebrandt, Connexions
    Training and Connexions Classroom Inc. and it’s staff from any and all liability arising therefrom.

  • MM slash DD slash YYYY
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