SACRED BREATHWORK EVENT WAVIER

::: IMPORTANT CONSIDERATIONS IN BREATHWORK :::

Below are a list of contraindications for Conscious, Connected Breathwork, a powerful breathing technique which changes blood oxygen levels in the body, safety alters our brainwave to a theta state, and allows us to access and unlock the subconscious body, emotional body, and occasionally the trauma body. We first and foremost want you to feel ready and available for this deep and transformative work!

Additionally, Breathwork results in certain specific physiological changes in our being and can result in intense physical and emotional release. As a precaution, the following conditions are contrandicated with Conscious, Connected Breathwork. It is crucial that you inform your Breathwork Practitioner if any of the following conditions are relevant to you.

IMPORTANT: You will not be able to experience The Sacred Breath Method if you have any contraindications listed below, however we may be able to offer you a modified, gentler format instead for some conditions. Please consult with us if you are contraindicated.

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::: CONTRAINDICATIONS FOR BREATHWORK :::

- Pregnancy (at any stage)

- Severe PTSD or Trauma

- Actively using recreational drugs

- Taking any medication that alters brain chemistry (like anti-anxiety, anti-depressant, ADD, OCD medications, etc.)

- Prescription Blood Thinners or Anti-Clotting Medications

- Osteoporosis

- Detached Retina

- Glaucoma

- Kidney Disease

- High Blood Pressure

- Cardiovascular Disease, including Angina, previous Heart Attack, or any other Cardiovascular issues like (myocarditis or pericarditis)

- Strokes or TIAs

- Seizures, history of seizures or other brain/neurological condition or disease

- Diagnosis of Aneurysm (of any kind)

- Uncontrolled Thyroid Conditions

- Diabetes (any type)

- Infectious or Contagious Disease

- Severe Asthma— for mild to moderate asthma, you can experience breathwork but must bring your inhaler to the session

- Epilepsy

- Prior diagnosis of Bipolar Disorder, Schizophrenia or previous Psychiatric Condition

- Severe Psychosomatic Disorders

- Recent Surgery, Stitches or Major Injury

- Hospitalization for any Psychiatric Condition or Emotional Crisis within the last decade

- Any other Medical, Psychiatric or Physical Conditions which would impair or affect ability to engage in any activities that involve deep physical and/or emotional release

Again, if you are on the contraindication list, you are not a candidate for the full breathwork technique, but we are happy to discuss modified, gentle breathwork with you as an alternative, so as long as changing oxygen levels in the body does not interfere with your condition. Exceptions would include diabetes, kidney and thyroid conditions.

ON THE WORK

Breathwork is an experiential practice and self-healing modality that uses conscious, connected breathing to access expanded states of consciousness while simultaneously unlocking repressed emotions and clearing stagnant energy from the mind, body and spirit. Through an intentional, safe and artful increase of oxygen levels, we activate different areas of the brain to create new neural pathways for deeper insights and heightened clarity, while meeting the essential root of unresolved emotional imprints.

The majority of breathers first experience deep (and at times, intense) emotional release or catharsis. It is possible to feel anything from grief/pain/discomfort to ecstasy/joy/bliss and anything in between. Again, these are parts of self that are not being met in waking life (even ecstasy and bliss can be energies that are being unconsciously repressed) and thus want the freedom to be completely and uninhibitedly expressed in a safe container of exploration, as we will create.

FINAL DISCLAIMER OF LIABILITY

Spiritual and emotional work, breathwork, yoga, meditation and any other form of alternative healing should not be construed as a substitute for direct medical advice from your doctor or other qualified clinician, medical or psychiatric examination, diagnosis or treatment. Anyone interested in breathwork is also responsible for seeking the specific medical or psychiatric attention they need, should they need it.

The information and content available is intended for informational purposes only. It is not intended to diagnose, mitigate, treat or cure any disease or condition. Individuals should consult a qualified health care provider for medical or psychological advice.

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NOTE: THE FOLLOWING IS A LEGALLY BINDING DOCUMENT. WE TRUST THAT ALL PERSONS WILL ANSWER IN HONESTY AND GOOD FAITH.

Name

First Name

Last Name

Email

Date of Birth

MM

DD

YYYY

Emergency Contact: Name + Phone Number

Do you have any contraindications to breathwork?

If so, please list below.

Do you have any other medical or psychological conditions that we should be aware of? If so, please list below. *

SELF-CONTRACT: 1 - I am ready to intimately meet myself (even in a growth edge) for my greater healing and transformation. INITIAL IF YOU AGREE

2 - Confirm that you have read and understood the SBA guidelines and contraindications list. *INITIAL IF YOU AGREE

3 - Confirm that you have NO contraindications listed to experience the full breathwork and have disclosed any existing medical conditions before the session. *INITIAL (unless previously stated otherwise)

4 - Confirm that you have read and agree to our disclaimer. *INITIAL

5- I, the Participant, understand that Breathwork is a powerful experiential tool for accessing my own inner healer and can greatly intensify my self-transformation. Through the art of deep diaphragmatic breathing along with the guidance of a skilled practitioner and intentional music, I will embark on a deep journey within. Because this process can potentially bring up intense emotions and strong physical experiences or sensations, I have been advised that it is not recommended for those with certain types of cardiovascular ailments or history of heart attack, epilepsy, recent surgery, pregnancy (at any stage), mental health imbalances, psychosomatic ailments, severe asthma, chronic disease, infectious disease, other physical limitations or unprocessed trauma. *INITIAL IF YOU AGREE

6 - I hereby acknowledge that I have no such problems or conditions as listed above, or any other physical, mental or emotional conditions that would prevent me from participating in a Breathwork immersion. I have fully disclosed my physical, mental and emotional background to the facilitators involved prior to my participation. I realize that all staff, assistants, volunteers and/or agents are here only as a guide to my process and that none of the staff, assistants, volunteers and/or agents are here to replace any form of traditional mental or health treatment. I have spoken with any and all mental and physical health care professionals that I believe would be necessary to ask whether I would be an appropriate candidate to participate in the Breathwork process, based on my physical, emotional and mental health history and current condition(s). I hereby attest that there is no reason why I should not be able to participate. * INITIAL IF YOU AGREE

7 - To this purpose, I, the Participant, voluntarily participate in the Breathwork Training with Sacred Breath Academy, and accept full responsibly for my own physical, mental, emotional and spiritual wellbeing, releasing and holding harmless Sacred Breath Academy and all affiliates. I am ready for this experience with a full-bodied YES! *INITIAL IF YOU AGREE

SACRED BREATHWORK EVENT WAVIER

::: IMPORTANT CONSIDERATIONS IN BREATHWORK :::

::: CONTRAINDICATIONS FOR BREATHWORK :::

NOTE: THE FOLLOWING IS A LEGALLY BINDING DOCUMENT. WE TRUST THAT ALL PERSONS WILL ANSWER IN HONESTY AND GOOD FAITH.

WELCOME TO THE SACRED BREATH EXPERIENCE!

in joyous reverence of breath

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