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Breathwork Liability Waiver

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For the purposes of this Breathwork Liability Waiver, the terms 'business/company/trading name' refers to the Australian Registered Business ‘Unearth Remedy’. The terms 'facilitator/practitioner/releasees' refers to 'Thea Williams', and any heirs, assigns, successors, employees, volunteers or associates of Thea Williams and/or Unearth Remedy. The terms 'activity/appointment/event/sessions' refers to the participation in Breathwork services and general advices provided by Unearth Remedy. The terms 'the Releasor/attendee' refers to the individual Participant listed at the bottom of this waiver
I understand, confirm and acknowledge that it is a condition of participating in any Breathwork services offer by Unearth Remedy, that:

1. The sessions provided by Unearth Remedy and the releasees are not intended to replace any relationship I have with my medical doctor and/or primary health care provider(s).

2. The sessions are not intended to constitute medical advice or any substitution for medical care.

3. The sessions are not intended to be relied on for prescriptions, recommendations, diagnosis, cure, or treatment in relation to any health problem or disease.

4. It is my responsibility to consult a health professional regarding any physical, mental, or emotional condition that could interfere with my judgment or affect my health during or after any session.

5. I am responsible for consulting my health care provider or doctor in case I have or suspect I am suffering from a health problem.

6. My participation is at my own risk.

7. The stories, reviews or testimonials presented either in session, online or printed promotional material do not constitute a warranty, guarantee, or prediction regarding my experience, outcome or results.

8. Unearth Remedy and the releasees makes no warranty, guarantee, or prediction about any particular state of awareness or consciousness during or after any session.

9. My participation does not establish a client-practitioner relationship or any other type of therapeutic or professional relationship between me and the facilitator. 10. I am not, and while participating in the session will not be, under the influence of alcohol or drugs unless any such drugs are prescribed by a Medical Practitioner and taken in accordance with that practitioner’s advice.

11. I agree to assume and accept full complete responsibility for any known and unknown risks associated with my participation in any session, including any physical injury, financial loss, psychological or emotional effects, death, loss, or property damage.

12. I release and discharge Unearth Remedy and its practitioners, contractors, employees, and agents from any and all claims, demands, causes of action, damages, or liabilities whatsoever, known or unknown, anticipated or unanticipated, suspected or unsuspected, arising out of or related to any and all sessions. 13. I agree to take personal responsibility for my breathwork process, including following post-session integration care instructions. 14. I have reviewed Unearth Remedy’s Breathwork Contraindications (listed below) and confirm that I do not currently or previously have or are being treated for any of the listed medical conditions or health concerns.

Breathwork Contraindications

For certain types of medical and health conditions, breathwork is not safe or suitable. With other conditions, we can be attentive and adjust your session accordingly. Contraindications that are not safe to practice breathwork, include:

- Aneurysm in brain or abdomen

- Currently taking/prescribed Blood Thinning Medications

- Cardiovascular disease (angina, previous heart attacks, or strokes)

- Detached retina

- Dissociative Identity Disorder (DID), previously known as multiple personality disorder

- All forms of Epilepsy

- Glaucoma

- High Blood Pressure

- Kidney disease

- Mental Illness (including Bipolar Disorder, Borderline Personality Disorder, Schizophrenia)

- Pregnancy

- PTSD

- Recent Surgery (6-months post-op minimum)

- Severe Asthma

- Any other medical, physical or psychiatric condition which would impair or affect the ability to involve in deep physical and emotional release.

Unearth Remedy reserves the right to request medical clearance if needed to ensure your safety.

Unearth Remedy reserves the right to refuse

I hereby read and confirm I DO NOT suffer from any of the Breathwork Contraindications listed and I am 18+ years old

I hereby read and confirm I DO NOT suffer from any of the Breathwork Contraindications listed and I am 18+ years old

Personal Details

First Name

Phone

Last Name

Email

Do you have any medical conditions or injuries we need to know about?

If you do not have any medical conditions or injuries, please state NONE.

I give consent for bodywork facilitations/physical touch to be used in my session

I give consent for bodywork facilitations/physical touch to be used in my session

I agree and give consent for photos and/or videos to be taken of myself to be used for social media, educational and/or promotional purposes

I agree and give consent for photos and/or videos to be taken of myself to be used for social media, educational and/or promotional purposes
Filming or photographing other participant's without their permission is strictly prohibited.

I sign this agreement voluntarily and with full knowledge of its implications. By signing electronically, I confirm that I have read, understood, and agree to the terms of this waiver,

Participant's Signature

Signature

Today's Date