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Men’s Reset by Renew Point –Tier 2 Application and Consent

This form is for the Men’s Reset pilot program. Complete the application below, review the consent information, and continue to payment.
This is a one-time payment for the full 4-week Men’s Reset program.
Includes weekly 30-minute 1:1 sessions in addition to live group sessions.
4-week structured experience focused on discipline, accountability, emotional regulation, and communication.

Full Name

Email Address

Phone Number (optional)

What are you currently struggling with that you want to work on?

What would success look like for you after these 4 weeks?

Are you able to commit to attending the weekly session and completing the weekly work?

Are you able to commit to attending the weekly session and completing the weekly work?
A
B

Informed Consent

Men’s Reset is a personal development and coaching-based pilot program for men. It includes weekly live sessions, a workbook, progress tracking, and structured reflection focused on discipline, accountability, emotional regulation, communication, and real-life application.

Men’s Reset is not therapy, counseling, or a substitute for mental health treatment. Participation is voluntary, and each participant is responsible for their own choices, actions, and follow-through.

Group discussions may involve personal sharing. Confidentiality is encouraged, but it cannot be guaranteed in a group setting.

By continuing, you acknowledge that you understand the nature of this pilot program and agree to participate responsibly.

Confidentiality and Use of Materials

Participants agree not to record, screenshot, or distribute any live sessions, discussions, workbook materials, or shared content.

This includes sharing content on social media, with friends, or in any public or private setting outside of the program.

This is a shared space built on trust, and all participants are expected to respect the privacy and contributions of others.

Please review the information above before continuing.

Please review the information above before continuing.
Your information will only be used for Men’s Reset communication, enrollment, and program administration.