Medical Contraindications for Breathwork

•     Epilepsy

•     Detached Retina

•     Glaucoma

•     Osteoporosis that is serious enough whereby moving around actively could cause potential issues.

•     High Blood Pressure that is not controlled with medication.

•     Cardiovascular disease and/or irregularities including prior heart attack

•     Prior strokes or seizures

•     Psychosis

•     If either you have had an aneurysm or iftwo members in your immediate family have had one.

•     Use of prescription blood thinning medications such as Coumadin  

•     Pregnancy

•     Asthma (if you have asthma you can participate but you must have your inhaler available)

I have voluntarily enrolled in this Breathwork activity. I understand that I am under no obligation of any kind to participate in this Breathwork activity and I voluntarily enter this into this Waiver and Release of Liability.

I understand the Breathwork is a personal growth experience designed to enhance the quality of life, is not a substitute for psychotherapy, and does not prevent, cure or treat any mental disorder or medical disease. I understand that I am responsible for creating and implementing my own physical, mental and emotional wellbeing, decisions, choices, actions, and results. As such, I agree that the Breathwork facilitator(s) is not and will not be liable for any actions or inaction, or for any direct or indirect result of services provided by the Facilitator(s). I understand that this Breathwork activity is not medically supervised and that Deidre Lee is neither licensed psychotherapists nor licensed medical professionals and that breathwork is not a substitute for any medical diagnosis or medical treatment.

I understand that this Breathwork activity will involve strong connected breathing and guided meditation. I understand that Breathwork can involve dramatic experiences accompanied by strong emotional and physical responses or releases.

I understand that I might find Breathwork physically, emotionally, and/or mentally stressful. I hereby affirm that I am in good health and able to participate in this activity. I have been made aware of medical contraindications and I attest that I do not have any physical or mental conditions which would impair my ability to engage in this activity or which would otherwise endanger my health during this Breathwork activity, or which would cause any risk of harm to myself or other participants.

I have hereby been advised that I should talk to my physician and/or psychotherapist if I had any questions about my physical or mental ability to safely participate in this preferred activity. If I have chosen not to obtain a physician's consent prior to my participation in Breathwork, I agree that I

am doing so solely at my own risk. I understand that is my responsibility to participate in activities that are appropriate for the current status of my health and to modify the Breathwork activity to accommodate my own needs or limitations.

I agree that if there is any change in this representation, I will promptly advise the Facilitator. If I have any questions or concerns about whether or not a particular activity is appropriate to my current health status, I understand it is my responsibility to ask my doctor before I participate in such activity.

I agreed to indemnify and hold harmless Deidre Lee from and against any and all claims and expenses, including attorney fees, arising out of my participation in this Breathwork activity. In consideration of my participation in this Breathwork activity, I hereby waive and release Deidre Lee and/or any assigns or beneficiaries from any and all claims, costs, liability, and expenses for any injury loss or damage whether known, anticipated, or unanticipated arising from my participation in Breathwork with Deidre Lee.

This Waiver and Release of Liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.

By signing this document, I am waiving certain rights I and/or my successors might have to bring legal action or assert a claim against Deidre Lee and/or any assigns or beneficiaries.

I acknowledge that I have thoroughly read this Waiver and Release of Liability in its entirety and fully understand it.