Language
English (UK)
Español
9D Breathwork Waiver Form - MUST BE SIGNED BEFORE SESSION
by The Reconnected Land
Please read the entire waiver form, please ask questions BEFORE submitting. Submitting your name and date implies acknowledgment of the waiver form and agreeing to the terms as an eSignature.
The safety and well-being of all the participants is my highest priority, and as part of my commitment to ensuring a secure environment, I require the completion of this Liability Waiver Form. A breathing session may not be suitable for you if you have the following conditions and your session may have to be modified if you have/are: - Cardiovascular problems - Abnormally high blood pressure - AneurysmsEpilepsy and seizures in the past - Taking heavy medication - Severe psychiatric symptoms especially psychosis or paranoia, bipolar - Osteoporosis - Recent surgery - Glaucoma - Currently pregnant - Experienced anaphalaxis - People with asthma should bring their own inhalers and consult with their physician and breathing session instructor before participating. - Experiencing an emotional or spiritual crisis or any person with a mental illness who is not in treatment or lacks adequate support. -------------------------------- *Please note, this list is not exhaustive, and generally advise that if you have a question about a condition, you may have that is not listed here, you consult a physician before participating in these breathing sessions. If you have any of the conditions above, please contact me on whatapp (+31 627375292 ) BEFORE you sign up for a journey to verify you have been cleared to participate. -------------------------------- I warrant and represent that I am in good health physically, mentally, psychologically, and emotionally, and I understand and warrant that if I am not in good health, I will not be allowed to perform the activities and sessions.Accordingly, the declaration and certification that I am in good health in all the above-mentioned respects constitute a material agreement to allow me to participate in the breathing sessions.I know and acknowledge that the person facilitating is not a doctor or psychiatrist, or a specialist in health care and that the activities offered are not intended to treat and diagnose specific medical conditions, whether physical, psychological, or emotional.I confirm I will not come to the session under the influence of any substance. I understand that by doing so will result in me being asked to leave and reschedule. No refund will be given.I voluntarily participate in these activities knowing the risks and consequences and agree to assume all consequences, known or not.I release my 9D Breathwork Facilitator, Daniela Fenton and her team, from all responsibilities, costs, and damages that may arise from participating in the above-mentioned activity. I agree to accept financial responsibility for costs related to treatment.By adding my name and date below, I acknowledge that I have read the above warning and agree to proceed with full responsibility and understand that I have waived certain rights by signing this release of liability freely and voluntarily without any external influence. I agree that submitting my name and date on this form count as an official eSignature.
*
At this moment in your life, are you experiencing any of these emotional states?
Sign Here
Enviar
Should be Empty: