PLEASE REVIEW | DURING THE REGISTRATION PROCESS, YOU WILL SIGN AND DATE THE FORM

Participant Waiver, Safety Agreement & Media Release

Welcome

Thank you for joining this breathwork experience. This session is designed to support nervous system regulation, emotional release, self-awareness, grounding, relaxation, and personal growth through guided breathing practices.

Breathwork can be a powerful and transformative modality. While many participants experience positive emotional, mental, physical, and energetic benefits, each person's experience is unique. For this reason, you are encouraged to participate with mindfulness, self-awareness, and personal responsibility.

My facilitation is grounded in a trauma-informed approach that prioritizes safety, consent, nervous system awareness, and personal choice throughout the experience.

Important Safety Information

Active breathwork practices may produce temporary physical, emotional, or energetic sensations, including but not limited to:

• Dizziness or lightheadedness

• Tingling sensations

• Muscle tension or tetany

• Changes in body temperature

• Emotional release

• Fatigue or increased energy

• Altered states of awareness

• Ear ringing

Although breathwork is generally considered a low-risk wellness practice for healthy individuals, it may not be appropriate for everyone.

If you have a medical condition or are unsure whether this style of breathwork is appropriate for you, please consult with your healthcare provider before participating. Medical clearance may be necessary for certain conditions.

Health Considerations & Participant Disclosure

You are welcome to discuss your concerns with me privately. Your comfort and personal boundaries will be respected throughout the session. Before participating, please let me know about any medical conditions, neurological disorders, physical limitations, sensory sensitivities, or other health concerns that may affect your experience during breathwork. You may modify your breathing, take a break, remove your headphones if needed, or stop participating at any time. Sharing relevant information helps me better understand your needs and whether participation or modifications may be appropriate. Your safety and comfort are important to me. Please understand that modifications may not eliminate all risks, and some conditions may make participation unsuitable.

Please speak with me privately before the session if you have any of the following, or other health concerns you believe may be relevant:

• Asthma or other respiratory conditions

• Neurological conditions, including epilepsy or a history of seizures

• Cardiovascular conditions or high blood pressure

• A history of fainting or loss of consciousness

• Tinnitus or sensitivity to sound or headphones

• Significant physical limitations or recent injuries

• Any medical or mental health condition that may affect your participation

Contraindications

This style of breathwork may not be suitable for individuals with any of the following conditions unless approved by a qualified healthcare professional:

• Cardiovascular disease

• Severe high blood pressure

• History of stroke or heart attack

• Aneurysm or family history of aneurysm

• Epilepsy or seizure disorders

• Glaucoma or retinal detachment

• Severe asthma or other significant respiratory conditions

• Osteoporosis

• Recent surgery or significant physical injury

• Severe mental health conditions, including psychosis

• Pregnancy

• Use of medications that may affect physical, emotional, or psychological regulation

Please note: If you have asthma or another respiratory condition, please discuss your participation with your healthcare provider beforehand and speak with me before the session. If you are approved to participate, please bring your prescribed rescue inhaler and keep it accessible at all times.

General Safety Guidelines

For your safety:

• Participate only in a safe, comfortable environment.

• Practice breathwork while seated or lying down.

• Listen to your body and honor your personal limits at all times.

• You may slow down, modify, pause, or stop the practice at any point.

Never practice active breathwork while driving, swimming, operating machinery, or in any environment where dizziness, altered awareness, or loss of consciousness could create a safety risk.

During our session, a wireless silent sound system, headphones, and guided microphone facilitation may be used to create a more immersive and focused experience.

Disclaimer & Release of Liability
By participating in this breathwork class, workshop, event, or course, I acknowledge that my participation is voluntary and that breathwork may involve physical, emotional, psychological, or energetic experiences that carry inherent risks.

I understand that I am solely responsible for monitoring my own physical, mental, and emotional well-being during and after participation. I acknowledge that breathwork is a wellness practice and is not intended to diagnose, treat, cure, prevent, or replace medical, psychological, or psychiatric care. To the fullest extent permitted by law, I voluntarily release, waive, and discharge Carrie Sloan, all facilitators, assistants, event hosts, venues, and affiliated organizations from any and all claims, liabilities, demands, actions, damages, losses, costs, or expenses arising out of or related to my participation in this breathwork experience.

Home Practice Responsibility

If I choose to practice breathwork outside of facilitated sessions, I understand that I am solely responsible for creating and maintaining a safe environment and for monitoring my own well-being throughout the practice.

Media Release
I understand that photographs and/or video recordings may occasionally be taken during sessions for educational, promotional, website, marketing, or social media purposes.

Participant Acknowledgment & Agreement

By signing below, I acknowledge and agree that:

• I have read and understand this Waiver, Safety Agreement, and Media Release.

• I understand the potential risks and benefits associated with breathwork.

• I have disclosed any relevant health conditions and, when appropriate, consulted with a qualified healthcare professional before participating.

• I understand that I may stop participation at any time.

• I voluntarily assume full responsibility for my participation and personal well-being.