GENERAL SAFETY TIPS

When practicing breathwork, being mindful of your environment and overall safety is important. Given the intensity and duration of the breathing, you may experience dizziness or feel light-headed. In some cases, although rare, you may lose consciousness. Therefore, we recommend you lay down on the floor, bed, or couch to ensure you do not harm yourself should you lose consciousness.

Furthermore, never practice this style of breathing while operating a motor vehicle, while in water (drowning can occur), or in any situation where you could harm yourself or others.

Release of Liability & Assumption of Risk

I voluntarily agree to enter this Release of Liability Waiver and Assumption of the Risk ("Waiver"). I recognize that I have voluntarily chosen to participate in today's and any future breathwork activities and events with Keisha Jordan, which include active breathing, somatic and meditation practice, to improve physical and emotional stability (“Breathwork”).

I recognize that the Breathwork session may result in moderate-to-vigorous physical activity associated with the breathing pattern practice. Breathwork may also result in physical side effects, which may include but are not limited to the temporary numbing of the mouth and other body parts, tingling sensation, cramping, muscle contraction, clenched hands (tetany), dizziness, visual disturbance, nausea, acute pain, release of tears, laughter, exhaustion, changes in blood pressure, among other temporary physical experiences. Breathwork may also result in temporary emotional volatility, including the possibility of anxiety and, rarely, auditory or visual hallucinations. I acknowledge these side effects and that participation in Breathwork may temporarily increase my risk of falling, collision with my surroundings or physical strain, which could cause personal injury (including but not limited to strains, fractures, pulling or tearing a ligament or muscle, partial and/or total paralysis or other ailments that could cause severe disability) and loss of or property damage. Despite these potential side effects and risks, I VOLUNTARILY ASSUME FULL RESPONSIBILITY FOR ANY RISKS OR LOSS, PROPERTY DAMAGE, OR PERSONAL INJURY, INCLUDING DEATH, THAT MAY BE SUSTAINED BY ME, OR LOSS OR DAMAGE TO PROPERTY OWNED BY ME, AS A RESULT OF PARTICIPATION IN THIS ACTIVITY.

I understand that Breathwork is not advised for persons who: 

• are pregnant or who might be pregnant;

• have a history of respiratory (lung or airway) conditions including but not limited to chronic obstructive pulmonary disease;

• have cardiovascular conditions including but not limited to high blood pressure, clotting disorders, strokes or aneurysms;

• have neurological conditions including but not limited to epilepsy;

• have kidney conditions, including but not limited to renal failure;  

• have diabetes; or

• have glaucoma, osteoporosis, severe mental illness or other recent physical injuries or surgery. 

I affirm that I am in good physical, psychological, and emotional health and either do not suffer from any of the above conditions or any known disability or condition that would prevent or otherwise limit my full participation in the Breathwork or have been medically cleared by my qualified healthcare professional to participate in Breathwork despite having these conditions and I have advised Keisha Jordan of these conditions. I will not participate in Breathwork under the influence of any alcohol or other substances. I will consult with my physician or other qualified healthcare professional before and regarding my participation in Breathwork and if I have any questions related to whether Breathwork is safe for me to participate in, and I will comply with their recommendations. I affirm that the Breathwork does not constitute psychological or medical advice.

I unconditionally and irrevocably release, waive, discharge, and covenant not to pursue any claim against Jen Schmidt or any of her employees, agents, consultants, independent contractors, volunteers, successors, assigns, or any other person or entity associated with the Breathwork activities and experiences offered (collectively referred to as “RELEASEES”), from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, damage, or injury (including, but not limited to death) that may be sustained by me, or to any property belonging to me, while participating in any Breathwork practice, or while on or upon the premises where the Breathwork is being conducted including, but not limited to, any claims arising under negligence, breach of contract, breach of warranty, or breach of any statutory or other duty of care of the RELEASEES. I understand and agree that this Agreement extends to and includes any and all damages, injuries, and claims which I do not anticipate or know to exist and to any and all damages, injuries, or claims which may develop in the future, and I hereby expressly waiver and relinquish any and all rights under any law or statute to the contrary.

To the extent allowed by law, I agree to defend, indemnify, and hold harmless the RELEASEES for all costs and expenses, including but not limited to all legal fees incurred by the RELEASEES in defending any claim brought against any or all RELEASEES by any releasing party including myself.

To the extent permitted by law, it is my expressed intent that this Waiver shall bind any and all members of my family including, but not limited to, my spouse, if I am alive, and my heirs, assigns, and personal representatives, if I am deceased. 

I further agree that this Waiver shall be constructed in accordance with the laws of Ontario, Canada. I further acknowledge that should I have any concerns regarding this Waiver, it is my responsibility to consult with an attorney before signing the Waiver.

I, THE UNDERSIGNED PARTICIPANT, AFFIRM THAT I AM OF THE AGE OF 18 YEARS OR OLDER, AND THAT I AM FREELY SIGNING THIS WAIVER. I CERTIFY THAT I HAVE CAREFULLY READ THIS WAIVER IN FULL, THAT I FULLY UNDERSTAND ITS CONTENT, AND THAT THIS WAIVER CANNOT BE MODIFIED ORALLY.