By signing up for the session, you are acknowledging that you have read and agree to the following:
Breathwork results in certain specific physiological changes in the body and also can result in intense physical and emotional release. As a precaution, the following conditions are contraindicated in certain breathwork practices.
High Blood Pressure (not controlled with medication)
Cardiovascular disease including angina, previous heart attack or stroke
Diagnosis of aneurysm in the brain or abdomen
Uncontrolled diabetes and thyroid conditions
Asthma – if applicable, please bring an inhaler to the session.
Prior diagnosis of bipolar disorder, schizophrenia or previous psychiatric condition.
Hospitalisation for any psychiatric condition or emotional crisis within the last 10 years.
Any other medical, psychiatric or physical conditions which would impair or affect ability to engage in any activities that involve intense physical and/or emotional release.
Potential participants may wish to consult with their primary care physician and seek a certified professional before engaging in breathwork therapy.
The practitioner for your breath work session, and Fire + Alchemy Ltd take no responsibility for any injury you may sustain as a result of participating in this session.
BREATHWORK RELEASE + WAIVER
By joining the this breathwork session, I agree to and understand that breathwork:
a) is not intended to replace any relationship I have with my medical doctor and/or primary health care provider(s);
b) is not intended to constitute medical advice or any substitution for medical care;
C) is not intended to be relied on for prescriptions, recommendations, diagnosis or treatment in relation to any health problem or disease;
I understand that if I am taking any medications or have any medical conditions such as, but not being limited to: schizophrenia, bi-polar, epilepsy, heart conditions, or pregnancy, that I must advise the facilitator/s. I also understand that even though I have been accepted as a participant, I am responsible for any consequence resulting from the breathwork session.
I certify that I have consulted a health professional regarding any condition physical, mental or emotional that could interfere with my judgment, or affect my health in any way during or after breathwork session.
I understand and acknowledge that I am responsible for consulting my health care provider or doctor in case I have or suspect to be suffering from a health problem.
I understand the stories or testimonials presented before or during the session do not constitute a warranty, guarantee, or prediction regarding my experience during or after the session.
The breathwork facilitators make no warranty, guarantee, or prediction that I will experience any particular state of awareness or consciousness during or after The Session, nor does it make any representation that I will experience any particular outcome on an issue. In the instance of a group processes I may voluntarily reveal personal information, in doing so I understand that and hereby waive my rights of privacy and confidentiality.
I further understand that my participation in The Session is not intended to create nor does it establish a client-practitioner relationship or any other type of therapeutic or professional relationship between me and the breathwork facilitators.
I understand that the breathwork Session could include a physical touch designed to support me in my path, and that I have the right to refuse this contact by using the word “stop”.
I understand and acknowledge that by participating in the breathwork session, I do it at my own risk. It is with this understanding that I voluntarily agree to this waiver.
Since the Session is experiential and the extent of the Session’s risks and benefits are not fully known, I agree to assume and accept full complete responsibility for any known and unknown risks associated with my participation in the Session, including any physical injury, psychological or emotional effects, death, loss, or property damage.
I agree and understand the Session may be filmed, photographed and/or recorded and that the breathwork facilitators shall have all rights in and to such film, photographs and/or recording, including the copyright therein. The copyright shall include, but not be limited to, the right to use, re-use, publish, and re-publish and otherwise reproduce, modify, and display any such film, photograph and/or recording for educational and promotional purposes, including without limitation, audiotapes, audio CDs, DVDs, websites, video, or film or any other form of recorded images. I grant the facilitators the right, without compensation to myself, to film, photograph
and/or record you while participating in the Session and I waive any right which I now have or may have hereafter in any such film, photograph and/or recording. I agree to not record by audio, video, photographic or any other means, any portion of the Session.
In my personal name, that of my heirs and assignees, I exonerate and totally and indefinitely release the relinquishers of any suit, complaint, declaration, damage, cost and / or expense of any kind (that any such prosecution, complaint, declaration, damage, cost and / or expense is caused by the passive or active negligence of the Releasees or otherwise) in connection resulting from any discussion, consultation and / or Session I had.
This agreement, and any dispute, controversy, proceedings or claim of whatever nature arising out of or in any way relating to this agreement or its formation (including any non-contractual disputes or claims), shall be governed by and construed in accordance with English law.