Breathwork Waiver & Liability Release Form

I understand that I am voluntarily participating in a breathwork session, which is an active meditation, experiential tool, and self-powered practice, that may include breath rhythms and techniques, focusing attention, intuitive guidance, somatic practices, and music to help access a non-ordinary state of consciousness.

This practice creates the circumstances for profound self-awareness, exploration, and personal growth and is not intended to be a substitute for medical or psychological treatment.

This process can bring up intense physical sensations and deep emotional experiences. Active breathwork has the potential to surface latent memories and energies, both desirable and undesirable.

I acknowledge that breathwork may involve physical, mental, and emotional effects including, but not limited to: tightness and/or vibration in the hands, mouth/jaw, tension or sensations throughout the body, feeling light-headed or activated, muscle cramps, changes to body temperature, increased heart rate or changes in blood pressure, and emotional release such as crying, laughter, or anger. It is rare, but possible that pre-existing conditions can become aggravated.

I understand that individuals with certain medical conditions - including but not limited to cardiovascular disease, high or low blood pressure, history of seizures, severe psychiatric conditions, or pregnancy - should consult a qualified healthcare provider before participating.

If attending virtually, I agree to keep my video on for the duration of the session so that the facilitator can clearly see me.

To the fullest extent permitted by Colorado law, I hereby release, waive, and discharge the facilitator, assistants, and associated venues from any and all claims, liabilities, demands, actions, or causes of action arising out of or related to my participation in breathwork sessions.

This release applies to any claims for personal injury, illness, emotional distress, property damage, or wrongful death, whether caused by negligence or otherwise.

I understand that the facilitator does not diagnose conditions or prescribe treatment and makes no claims regarding specific results.

This agreement shall be binding upon me, my heirs, executors, administrators, and legal representatives. If any portion of this agreement is found unenforceable, the remaining provisions shall remain in full force and effect.

The potentials mentioned are for my understanding and agreement. They are not guaranteed experiences.