WAIVER & RELEASE FORM

REBIRTH & SHAMANIC BREATHWORK JOURNEY


Acknowledgment & Assumption of Risk:

I realise that Rebirth/Shamanic Breathwork is a powerful experiential tool for accessing my own inner healer and can greatly intensify my transformational process. Through deep core breathing and chakra-attuned music, I will embark on a journey into the soul. Because this process can bring up intense emotions and strong physical experiences, I acknowledge that I have been informed of the possible effects, including but not limited to:
  • Dizziness, tingling, or light-headedness
  • Emotional release or catharsis
  • Temporary changes in consciousness
  • Increased heart rate, body temperature, or energy shifts
I understand that while Rebirth/Shamanic Breathwork is generally safe, it is not recommended for individuals with certain medical conditions, including but not limited to:
  • Cardiovascular disease, high blood pressure, or history of stroke
  • Epilepsy or history of seizures
  • Glaucoma or detached retina
  • Severe mental health conditions (e.g., schizophrenia, bipolar disorder)
  • Pregnancy
  • Recent surgery, physical injuries, or serious medical conditions
I confirm that I have consulted my healthcare provider if I have any concerns about my ability to participate in Rebirth/Shamanic Breathwork.

I hereby acknowledge that I have no such medical conditions as listed above, or any other physical, mental, or emotional conditions that would prevent me from participating.

I have fully disclosed my physical, emotional, and mental background to Journey of Self prior to my participation in this process. I understand that the facilitators, assistants, agents, and/or volunteers of Journey of Self are here only as guides to my process. None of them are here to replace any form of traditional mental or physical health treatment or spiritual modalities. I have consulted any and all mental and physical health care professionals I believe necessary to assess whether I am an appropriate participant for the Rebirth/Shamanic Breathwork process, based on my physical, emotional, and mental health history and current conditions. I attest that there is no reason why I should not be able to participate.



Release of Liability:

I voluntarily assume full responsibility for any risks, injuries, or discomfort that may arise from my participation. I hereby release and hold harmless Journey of Self, its facilitators, assistants, agents, and any associated individuals or organizations from any claims, liabilities, or damages arising from my participation.
This release applies to all acts or omissions, whether related to the grounds, premises, staff, assistants, agents, and/or volunteers.
I understand that this breathwork session is not a substitute for medical, psychological, or psychiatric treatment, and no guarantees are made regarding specific outcomes.



Confidentiality & Personal Responsibility:

I agree to respect the confidentiality of other participants and acknowledge that I am responsible for my own well-being during and after the session. I will communicate any discomfort or concerns to the facilitator immediately.



Consent & Agreement:

By clicking below, I confirm that I have read and fully understand this waiver and release form. I voluntarily agree to participate in Rebirth/Shamanic Breathwork and accept full responsibility for my experience.



Important Information:

Mild/minor conditions: 
You may be still able to participate with some mild/minor conditions using a relaxed gentle breathing method. Connect with me to discuss your individual case.

Connect with me:
If you have any other concerns or there something you would like to discuss that is not on the form feel free to contact me at bec@journeyofself.com.au or 0433856053

Remember to remind your fascilitator of any new or previously discussed conditions prior to your breathwork session as your safety is our number one priority.




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