So I can make sure you have the safest experience possible, please answer the following questions honestly. If you are unsure about any condition, please consult your GP before attending.
PLEASE READ! By filling out and submitting this form, you are also agreeing to the conditions below.
I/we prioritize the safety and well-being of all our participants, and as part of our commitment to ensuring a secure environment, we require the completion of this Liability Waiver Form. A breathing session may not be suitable for you if you have the following conditions: Cardiovascular problems, abnormally high blood pressure, aneurysms, epilepsy and seizures in the past, anyone taking heavy medication, severe psychiatric symptoms especially psychosis or paranoia, bipolar, osteoporosis, recent surgery, glaucoma or is currently pregnant. People with asthma should bring their own inhaler and consult with their physician and breathing session instructor before participating. Anyone 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 we 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.
I confirm that I have not consumed alcohol or recreational drugs in the 24 hours prior to this session, and that I am not currently under the influence of any substance that could affect my ability to safely and fully participate in this breathing session.
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 constitutes 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 voluntarily participate in these activities knowing the risks and consequences and agree to assume all consequences, known or not. I release trainer Stephanie Ziino, Simon Braun and anyone assisting them 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 submitting this form, 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.
MEDIA RELEASE
By proceeding with this booking, I confirm that I understand photos/videos may be taken during the event for marketing, promotional, and educational purposes. I provide consent and I agree to allow photos and/or videos to be taken, knowing these will be taken with consideration and care of all participants. I release Stephanie Ziino, Simon Braun and their team from any claims related to the use of these materials.