I realize that participation in any Breathwork Practice could involve some possible
personal injury. Despite precautions, accidents and injuries may occur. By signing this release
form, I assume all risks related to the use of any and all spaces used
By Aine Rock, Facilitator.

I agree to release and hold harmless Aine Rock, facilitator and facilities used from any cause of action, claims, or demands now and in the future.

I will not hold Aine Rock lliable for any personal injury or any personal property
damage, which may occur on the premises before, during or after classes or workshops.

If at any time during the class, you feel discomfort or strain, gently come out of the posture. You may rest at any time during the class. If I experience any pain or discomfort, I will listen to my body and inform my teacher immediately. I, the undersigned, understand that Breathwork and movement is not a substitute for medical attention, examination, diagnosis or treatment.

I recognize that it is my responsibility to notify my facilitator of pregnancy, any serious illness or injury before every class. I affirm that I alone am responsible to decide whether to practice.
I hereby agree to irrevocably release and waive any claims that I have now or hereafter may have against Aine Rock

Breathwork may not be for you if you have the following conditions:

Cardiovascular problems
High or abnormal blood pressure
History of aneurysms
Epilepsy or history of seizures
Anyone on heavy medication
Severe psychiatric symptoms, particularly psychosis or paranoia
Bipolar depression
Osteoporosis
Recent surgery
Glaucoma
Pregnancy
An active addiction
Any person with mental illness who isn’t in treatment or lacks adequate support
Anyone experiencing an emotional or spiritual crisis
This list is not all inclusive and we generally recommend if you have a question about a condition you may have that is not listed, that you consult a physician before beginning breathwork.

If you have or have had any of the listed conditions, we strongly recommend you consult a physician before beginning breathwork.

By checking this box, you acknowledge that you have read the above warning and agree to move forward at your own risk.