Breathwork Informed Consent:

Breathwork refers to any type of breathing exercise or technique in which a person intentionally changes their breathing pattern. There are many forms of breathwork therapy that involve breathing in a conscious and systematic way, often performed to improve mental, physical, and spiritual well-being. Breathing itself can last for anywhere from 30 to 90 minutes depending on the participants individual journey and what the facilitator deems appropriate for the session.

 

The participant is simply asked to remain open to whatever kind of experiences present themselves during the breathwork session. This can include, but is not limited to, deeply restful or ecstatic states, vivid reliving of past experiences, release of energy from the body, tetany of the hands, feet, legs or face, strong tingling sensations, strong emotions (either pleasant or difficult), spiritual experiences or experiences from other transpersonal areas of consciousness.

 

The facilitator’s role during the session is to oversee the breathing cycle and ensure it is maintained, as well as perform direct and non-direct forms of bodywork.

 

Breathwork is a powerful experiential tool for accessing altered states of consciousness. As this process can bring up intense emotions and strong physical sensations in some, it is not recommended for those with certain types of conditions including: 

1) Epilepsy
2) Pregnancy
3) Detached Retina
4) Glaucoma
5) High Blood Pressure that is not controlled with medication
6) Cardiovascular Disease including but not limited to prior heart attack
7) Use of Prescription Blood Thinners such as Coumadin
8) Hospitalization for any psychiatric condition or emotional crisis within the last 10 years
9) History of Aneurysms in immediate family
10) Strokes, TIAs, seizures or other brain/neurological condition or disease
11) Prior diagnosis by a health professional of bipolar disorder or schizophrenia
12) Osteoporosis whereby intense movement could cause physical issues
 

NOTE: ASTHMA IS NOT A CONTRAINDICATION BUT WE ASK THAT YOU BRING YOUR INHALER TO THE WORKSHOP IF YOU HAVE ASTHMA

 

If you have any doubt about whether you should participate, consult your physician or therapist, as well as your facilitator before attending.

 

Breathwork may activate a heightened emotional state which can continue beyond the time of the breathwork session, for which post session therapy and support is recommended. Breathwork is intended as a personal growth experience and should not be looked upon as a substitute for psychotherapy.

 

For the safety of the participants, the facilitator reserves the right to discontinue services based on contraindications including, but not limited to, those listed above.

 

Waiver Statement:

In order to participate in the event I hereby:-

• Release Rebel Soul Health from any liability now or in the future for any injury caused, occurring during, or after, my participation in a Rebel Soul Health event or service.

• Agree to assume full responsibility for all injuries or damage which are sustained or aggravated by me in relation to a Rebel Soul Health event or service.

• Release, and indemnify Rebel Soul Health, subsidiary affiliates, and each of their respective representatives from all responsibility, claims, actions, suits, expenses, damages, and liabilities to the fullest extent allowed by law.

• Affirm that I have no medical or physical condition that would prevent me from fully participating in a Rebel Soul Health event or service.

• Verify that I do not have a physical or mental condition that would put me in any physical or medical danger.

• I acknowledge that if I have any chronic disabilities or conditions, I am at risk by participating in a Rebel Soul Health event or service.

• I understand that Rebel Soul Health events and services are intended as personal growth experiences and should not be used as a substitute for psychotherapy and that the facilitator/s are not acting as psychotherapists.

• I understand that breathwork may involve vivid somatic experiences, accompanied by strong emotional and physical sensations.

• I understand that since my experience will be unique, despite any representations made by the facilitators, or in any websites or other marketing materials relating to a Rebel Soul Health event or service, the facilitator/s cannot guarantee that participating in the session will lead to any specific type of experience, result, or benefit.

• I acknowledge that consuming alcohol or mind-altering substances prior to this service is not permitted. Facilitator/s may refuse my participation if they feel I may be negatively affected by any substances.

 

Publicity Release:

I agree that Rebel Soul Health may photograph and record me and may use these photographs and recordings for promotional purposes. I give my consent to Rebel Soul Health that they may display photographs and recordings of my image online, through websites and social media platforms to promote Rebel Soul Health business and operations. I have the right to refuse my image being shared publicly at any stage, and agree to notify the facilitator of this decision.

 

Refund Policy:

I understand that if I cancel my booking within 24 hours of the booking, that I will be required to pay the full amount and will not be entitled to any reimbursement for any reason.

 

I have read Rebel Soul Health Waiver and Release, fully understand its terms, and understand that I am giving up my right to take legal action against Rebel Soul Health. I acknowledge that I am signing this waiver freely and voluntarily. The term of this waiver is indefinite