PARTICIPANT CONTRACT

RELEASE, WAIVER, AND INDEMNITY OF LIABILITY AGREEMENT

This Participant Contract and Release, Waiver and Indemnity of Liability Agreement (hereinafter "Agreement") is entered into by ("Participant") and BRIANNE STAGGS, MANDALA BREATHWORK ("Organizer"). In consideration of being admitted to the Program and permitted to participate in the activities and Neurodynamic Breathwork ("NDB"). The Parties hereby agree as follows:

1. This Agreement is made and entered into under the laws of the State of North Carolina and the United States and shall be interpreted, governed and enforced under and pursuant to these laws.

2. Participant agrees that should an action be brought against Organizer and/or any Neurodynamic Breathwork Facilitators or Apprentices working at the Program for any reason whether to enforce the terms of this agreement or on some other basis, that all disputes between Participant and Organizer will be litigated in Wake County, North Carolina and Participant waives any rights he/she may have in litigating in any other jurisdiction.

3. Participant has been informed of and understands medical contraindications, and certifies that he/she does not have any medical or physical conditions which would impair or affect his/her ability to engage in any activities or which would cause any risk of harm to Participant, other participants and/or any participating Neurodynamic Breathwork Facilitators or Apprentices or otherwise endanger Participant's health while attending an [Organizer] Program. Participant further agrees that it is Participant's responsibility to maintain the accuracy and contemporaneousness of the Medical Information Form. Organizer will assume that the Participant's Medical Information Form is correct until the Participant files an updated or corrected form. The medical information is fully incorporated by reference within this agreement.

4. Participant is aware that certain activities he/she may engage in during the Program are physically, emotionally and/or mentally stressful. Among other processes, it will include breathing that is faster and deeper than normal over a prolonged period which can cause dizziness, palpitations, tingling/numbness of the extremities, carpopedal spasms [involuntary contractions of the muscles of the hands and feet], tetany, ringing/roaring in the ears, clouded/distorted vision, perceptual distortions, and feelings of lightness, astonishment and/or euphoria. Physical Activities can also include violent twisting and turning while prostate and other exertions not normally engaged in by Participant. Loud music is also used with the described activities.

5. Participant agrees to assume full responsibility for his/her own physical, emotional and mental health and hold harmless Organizer, and/or any Neurodynamic Breathwork Facilitators and Apprentices working with organizer at the Program from any physical, emotional and/or mental damage that may be attributed to the Program or any participation therein. Participant further holds harmless Organizer from any and all loss, liability, injury, damage or cost which may arise out of or in connection with participation in the Program.

6. Participant understands that this Neurodynamic Breathwork Event is intended as a personal growth experience and should not be used as a substitute for psychotherapy.

7. Participant acknowledges that he/she has been fully advised concerning the types of activities which will be engaged in during the program, and understands the risks and difficulties that may arise during the program. Participant understands that he/she may leave at any time subject to the understandings and representations in the Medical Release Form, which is incorporated herein by this reference. Participant understands that by executing this release and engaging in the program, he/she is assuming those risks which are inherent to the activities involved.

8. I understand that since my experience will be guided by my own psyche/inner healer, despite any representations made by any of your staff, or in any of your websites or other marketing materials regarding Breathwork workshops, Organizer cannot guarantee any specific type of experience, result or benefit from participating in the workshop. I also understand that once the workshop begins, I will not be entitled to any return or reimbursement of any of my workshop tuition for any reason.

9. Participant understands that contra-indications may exist for the anticipated activities if Participant is or has been suffering medical or psychological/psychiatric conditions requiring professional care; and that the activities described can also trigger repressed traumas. Hence, Participant represents that he/she is not currently, nor for the preceding five years been, under the treatment and care of a physician or therapist for any condition, nor has he/she been diagnosed for any condition or currently taking any medication or mind altering substance, except as expressly disclosed in the Medical Information Form; and failure to disclose same constitutes a basis for disqualification and dismissal from the program, and shall be deemed a knowing and voluntary waiver and complete release of any claim against Organizer as more specifically described in Section 16 and related provisions herein.

10. Participant understands and agrees that he/she is attending the Program at the discretion of Organizer and can be dismissed from the Program at any time without being informed of the reason for dismissal. Participant also understands and confirms his/her agreement that Organizer makes no guarantee of any type of experience or any experience whatsoever [see also the Medical Release Form, which is incorporated herein by this reference].

11. Participant understands that he/she may not record - audio or video - any portion of these sessions or any persons participating therein. Still photographs will not be taken of any person except with the advance consent of the person being photographed.

12. Participant understands and agrees that Organizer is not responsible for property that is lost, stolen, or damaged while in, on, or about the premises.

13. Participant acknowledges that he/she has been advised (a) concerning the types of activities which will be engaged in during the Program, and understands the risks and difficulties that may arise during the Program; and (b) that if Participant feels too uncomfortable to continue at any point during the breathwork, he/she is to stop immediately and check in with Organizer before continuing. Participant understands that he/she may decline to do any of the activities. Participant understands that by executing this release and engaging in the Program, he/she is assuming those risks which are inherent to the activities involved.

14. Participant acknowledges, understands, and agrees that this Agreement, and all of the releases, terms and conditions contained herein, shall apply with equal force and govern any future Neurodynamic Breathwork Programs in which participant partakes with Organizer thus obviating the need for me to sign this Agreement each and every time I partake in any Neurodynamic Breathwork activities or events. Participant further agrees to bring any changes in their Medical condition to Organizer's attention before participating in any Neurodynamic Breathwork event.

15. If Participant is under 18 years of age, participant must have one of his/her parents or guardians present at the Program.

16. Participant waives, releases and discharges any and all claims, rights and/or causes of action which he/she now have or which may arise out of or in connection with participation in the Program as well as which may arise out of or in connection with Participant's attendance and/or participation in the activities associated with the Program. Therefore, under no circumstance will Participant prosecute or present any claim for personal injury, property damage or any other cause of action against Organizer and/or and participating Neurodynamic Breathwork Facilitators and Apprentices. See also Medical Release Form, which is incorporated herein by this reference.

17. This agreement is binding on Participant's heirs, assignees, dependents, personal representatives and

18. No oral representations, statements or inducements have been made to Participant to cause them to enter into this agreement.

19. At the choosing of Organizer and/or any participating Neurodynamic Breathwork Facilitator or Apprentice any claim or controversy that arises out of or relates to this agreement, or the breach of it, may be settled by arbitration in accordance with the rules of the American Arbitration Association. Such arbitration shall be binding upon the parties and Judgment upon the award rendered may be entered in any court with jurisdiction.

20. Should Organizer and/or any participating Neurodynamic Facilitator or Apprentice be successful in bringing an action to enforce the terms hereof or successful in defending itself from a suit brought by Participant, Organizer and/or any participating Facilitator and/or Apprentice shall recover all costs and expenses incurred in such action, including reasonable attorneys' fees.

21. Should any provision of this Agreement be held invalid or illegal, such illegality shall not invalidate the remainder of this Agreement. In that event, this Agreement shall be construed as if it did not contain the invalid or illegal part, and the rights and obligations of the parties shall be construed and enforced accordingly.

I have read this agreement, incorporated herein by this reference, and understand it contains release of all claims language for injuries and damages. I voluntarily sign my name evidencing acceptance of the provisions of this agreement. If English is not my native language I have either studied enough English to be able to read and understand this agreement, or I have had this agreement explained to me in my native language.