Client Authorization for Your Goals Form

Client Authorization for Your Goals Form

Parties

Client Name:

Service Provider Name:

Client Contact Email:    Client Phone:

Provider Contact Email:    Provider Phone:

Recitals

WHEREAS, Client desires professional assistance from Provider to define and pursue certain personal, professional, or business goals as described in this authorization; and

WHEREAS, Provider represents that it possesses the experience, personnel, and capacity to assist Client in establishing and pursuing the stated goals, and Client wishes to retain Provider for such services under the terms set forth below; and

WHEREAS, the parties intend for this document to constitute the complete authorization and agreement by which Provider is authorized to act on Client's behalf with respect to the goals and associated activities described herein.

Scope of Work

Specific deliverables and milestones will be detailed in writing and appended as exhibits where applicable. Provider is authorized to take reasonable actions consistent with the Scope of Work, including but not limited to planning, coordination with third parties, documentation, and regular progress reporting to Client.

Payment Terms

Late Fee:    Late Fee (Flat):

All fees are due as invoiced. If payment is not received within the time specified in the Payment Schedule, Provider may suspend performance until outstanding amounts are paid in full. Client shall also reimburse Provider for reasonable costs of collection, including attorneys' fees.

Term and Termination

Effective Date:    Term End Date:

Termination for Cause: Either party may terminate this Agreement immediately upon written notice if the other party materially breaches any obligation hereunder and fails to cure such breach within the notice period specified above. Termination shall not relieve Client of the obligation to pay for services performed and costs incurred through the effective date of termination.

Confidentiality

Each party acknowledges that during the term of this Agreement it may receive Confidential Information of the other party. "Confidential Information" means non-public information that is designated as confidential or that reasonably should be understood to be confidential given the nature of the information. Confidential Information does not include information that: (a) is or becomes publicly available through no fault of the recipient; (b) was rightfully known to the recipient prior to disclosure; (c) is lawfully obtained from a third party without restriction; or (d) is independently developed by the recipient without use of the disclosing party's Confidential Information.

Each party shall: (i) hold the other's Confidential Information in strict confidence; (ii) use such Confidential Information only for the purposes of performing its obligations under this Agreement; and (iii) limit disclosure to employees or agents who have a need to know and are bound to maintain confidentiality. The obligations in this section shall survive termination of this Agreement for a period of years.

Client Authorization and Data Use

Client hereby authorizes Provider to act as described in the Scope of Work and to take such actions as are reasonably necessary to pursue the agreed goals. This authorization includes, where applicable, contacting third parties on Client's behalf, collecting and maintaining records related to Client's goals, and preparing documentation required to achieve agreed outcomes.

Client consents to the following (select all that apply):

  Provider may contact third parties necessary to achieve Client's goals (referrals, partners, vendors).
  Provider may use anonymized, aggregated data derived from Client's engagement for internal analysis and service improvement, provided no identifying information is disclosed.
  Provider may send Client non-essential communications and notices regarding services (Client may withdraw this consent at any time).

Client acknowledges that certain outcomes cannot be guaranteed and that Provider's authority is limited to the scope agreed in this document. Provider will not enter into any legally binding contracts on behalf of Client without separate written authorization.

Governing Law; Dispute Resolution

This Agreement shall be governed by and construed in accordance with the laws of the state indicated by Client and Provider as their mutual choice of law: . Any dispute arising out of or relating to this Agreement shall be resolved through good faith negotiation; if unresolved, the parties agree to submit the dispute to binding arbitration under commercially accepted arbitration rules, with the arbitration to be conducted in the county of the governing law state unless otherwise agreed in writing.

Entire Agreement

This document, together with any attachments and executed exhibits, constitutes the entire agreement between Client and Provider with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, representations, and understandings of the parties. Any amendment must be in writing and signed by both parties.

Certifications and Notices

By signing below, each party certifies that the information provided in this form is true and accurate to the best of their knowledge, that they have the authority to enter into this Agreement, and that they understand and accept the terms and conditions set forth herein.

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