1. WHAT IS BREATHWORK?

Breathwork is a guided practice using controlled breathing techniques to influence physical, emotional, and energetic states.

Sessions may involve deep or rhythmic breathing, sound, movement, or emotional expression.

Breathwork can support relaxation, emotional release, clarity, and self-awareness. Most people experience breathwork as safe and beneficial, yet—like any intense physical or emotional practice, it may trigger temporary reactions in the body or mind.

By signing this document, the participant acknowledges understanding and accepting these possibilities.

2. PARTICIPANTS ACKNOLEDGEMENT

The participant confirms the following:

A. Voluntary Participation

I am choosing to participate fully voluntarily. I understand I may pause, modify, or stop the session at any time.

B. Health Considerations

I confirm that I am responsible for monitoring my own physical and emotional state.

I will inform the facilitator of any medical or psychological conditions relevant to my participation.

C. Personal Responsibility

I understand that I am responsible for my own wellbeing during and after the breathwork session.

I agree to listen to my body and respect my own limits.

3. POSSIBLE EFFECT DURING BREATHWORK

During breathwork, it is common to experience:

– Emotional release (crying, laughter, anger, sadness)

– Physical sensations (tingling, temperature changes, muscle tension, tremors)

– Changes in breathing rhythm or heart rate

– Lightheadedness, dizziness, or temporary altered states of consciousness

– Memories, insights, or strong internal imagery

These responses are typically temporary and part of the breathwork experience. If at any moment I feel overwhelmed, I can return to a natural breath, open my eyes, or ask for support.

4. MEDICAL CONTITIONS & CONTRAINDICATION

I confirm that I do not have any of the following conditions, or if I do, I have obtained explicit medical clearance:

– Severe or uncontrolled cardiovascular conditions

– High blood pressure not stabilized by medication

– History of stroke, seizures, or epilepsy

– Severe respiratory issues (COPD, severe asthma, chronic lung disease)

– Recent surgery or physical injury that could be aggravated

– Severe mental health conditions (psychosis, bipolar disorder I, dissociative disorders, schizophrenia)

– Use of medications that significantly alter neurological or cardiovascular function

– Any condition where intense breathing or emotional activation could be unsafe

5. RELEASE OF LIABILITY

By signing this form:

I release the facilitator from all liability for any injury, emotional reaction, or consequence, physical, mental, or energetic that may occur during or after the session.

I understand that breathwork is not a substitute for medical or psychological treatment, and the facilitator does not diagnose, treat, or prescribe.

To the fullest extent permitted by law, I waive any claim against the facilitator arising from my conscious participation.

6. CONFIDENTIALITY

Personal sharings, emotional experiences, and conversations during the breathwork session are confidential. The facilitator agrees to respect my privacy, and I agree to respect the privacy of other participants (if in a group session).

7. SOCIAL MEDIA CONSENT

You are free to choose whether you want to appear in photos or videos.

I will always use any content with care, respect.

The purpose of sharing this media is simply to help others discover this work, just like you did.

If you give your consent, you can withdraw it at any time. If something is published and you change your mind, you can ask for it to be removed, and it will be done without question.

Please indicate your choice: