LIABILTY WAIVER
I (the client) have voluntarily enrolled in this Holosomatic® activity. I understand that I am under no obligation of any kind to participate in this activity, and I voluntarily enter this into this Waiver and Release of Liability.
I understand that this session is a personal growth experience designed to enhance the quality of life and is not a substitute for psychotherapy and does not substitute for therapy if needed. I understand that I am responsible for creating and implementing my own physical, mental and emotional wellbeing, decisions, choices, actions, and results. As such, I agree that the session Facilitator(s) is not and will not be liable for any actions or inaction, or for any direct or indirect result of services provided by the Facilitator(s). I understand that this Holosomatic® activity is not medically supervised, and that the Facilitator(s) are neither licensed psychotherapists nor licensed medical professionals, and that breathwork is not a substitute for any medical diagnosis or medical treatment.
I understand that this Holosomatic® activity will involve various breathing patterns, vocalization, movement, meditation, and may include therapeutic touch (optional).. I understand that Holosomatic® therapies can involve dramatic experiences accompanied by strong emotional and physical responses or releases. I understand that I might find this activity physically, emotionally, and/or mentally challenging.
I hereby affirm that I am in good health and able to participate in this activity. I do not have any physical or mental conditions which would impair my ability to engage in this activity or which would otherwise endanger my health during this Holosomatic® activity, or which would cause any risk of harm to myself or other participants.
Contraindication are conditions in which breathwork is NOT advised.
THE FOLLOWING LIST OF CONTRAINDICATIONS SHOULD BE CAREFULLY REVIEWED BY THE PARTICIPANT (AND DISCUSSED WITH A MEDICAL PROFESSIONAL IF NECESSARY):
– Pregnancy
– Epilepsy
– Detached retina
– Glaucoma
– Uncontrolled high blood pressure
– Cardiovascular Diseases (including prior heart attack)
– Diagnosed mental disorders (manic disorder, bipolar disorder, schizophrenia, paranoia, psychotic episodes, depersonalization, etc.)
– Strokes, TIA´s, seizures or other brain/neurological conditions
– A history of aneurysms in your immediate family
– Use of prescription blood thinners
– Hospitalized for any psychiatric condition or emotional crisis within the past 5 years
– Osteoporosis or physical injuries that are not fully healed
– Acute somatic and viral diseases
– Acute physical injuries or recent surgeries (must receive clearance from medical provider)
– Contagious illness or infection
– Chronic obstructive pulmonary disease (COPD-II and COPD-III)
– Chronic diseases with symptoms of decompensation or terminal illness
– Individual intolerance of oxygen insufficiency
– Cancer, unless IHT is prescribed by a doctor
– **Asthma** it is ok to participate but you MUST bring your inhaler/medication
-- Fasting (more than 6 hours; intermittent fasting is ok)
I (the client) understand that if any of the above mentioned conditions are applicable to me, I am obliged to inform the facilitator AHEAD of time. I have hereby been advised that I should talk to my physician and/or psychotherapist if I had any questions about my physical or mental ability to safely participate in this Holosomatic® activity. If I have chosen NOT to obtain a physician's consent prior to my participation in this activity, I hereby agree that I am doing so solely at my own risk. I understand that it is my responsibility to participate in activities that are appropriate for the current status of my health and to modify my participation in the activity to accommodate my own needs or limitations. I agree that if there is any change in this representation, I will promptly advise the Facilitator(s). If I have any questions or concerns about whether a particular activity is appropriate to my current health status, I understand it is my responsibility to ask my doctor and/or the session Facilitator(s) before I participate in such activity.
Code of Conduct and Ethics
Respect and Courtesy: All participants must treat each other, the facilitator/s, and the environment with respect and courtesy at all times.
Confidentiality: Personal information shared during the event is to be kept confidential.
Consent: Explicit consent is required for any physical contact during the in person activities.
Substance Use: The use of recreational drugs or alcohol is strictly prohibited during the event. Refrain from using substances for at least 24 hours prior to the event.
Participation: Participants should engage in activities to the best of their ability, respecting their own physical and mental limits.
I agreed to indemnify and hold harmless the Facilitator(s) and the Company and their respective directors, officers, employees, agents, and beneficiaries from and against any and all claims and expenses, including attorney fees, arising out of my participation in this Breathwork activity. In consideration of my participation in this Holosomatic® activity, I hereby waive and release the Facilitator(s) and/or any assigns or beneficiaries from any and all claims, costs, liability, and expenses for any injury loss or damage whether known, anticipated, or unanticipated arising from my participation in Breathwork with the Company and the Facilitator(s).
This Waiver and Release of Liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. I acknowledge that I have thoroughly read this Waiver and Release of Liability in its entirety and fully understand it.
By completing this form, I am waiving certain rights I and/or my successors might have to bring legal action or assert a claim against the Facilitator(s) and/or any assigns or beneficiaries.
Please read all of our waiver info on this page and complete the form before participating in any sessions or events with Respire with Lisa.