BREATHWORK WAIVER AND RELEASE OF LIABILITY

In consideration of being permitted to participate in any way in breathwork treatments, as well as any related activities (collectively, “Breath work Activity”) with Beth Larsen Coaching,  LLC and its instructor, Beth Larsen (“Instructor”), I (name stated below), hereby acknowledge, understand and agree to the following Waiver and Release of Liability (“Release”):

1. Breathwork Activities are a self-healing technique and modality in which I use my own breath to move and release energy within my body. As such, I recognize that Breathwork Activities require emotional, physical, and mental effort, exertion, and behavioral experimentation, on my part, which may cause physical, mental, psychological or emotional side effects or injury. I fully acknowledge and take full responsibility for all the risks involved in Breathwork Activities and I assume any risk in such participation. Any actions or lack of actions taken on my part of such participation is done solely by choice and responsibility, and any harm, death, injury or loss that may occur to me or my property as a result of my participation in Breathwork Activities, are neither the responsibility nor liability of Beth Larsen Coaching, LLC or Instructor. In the event that I am injured, I agree to assume any financial obligation, either through my personal health insurance, or through some other means, for any medical costs I incur. Beth Larsen Coaching,  LLC and Instructor assume no responsibility for any medical expenses, injury, or damage suffered by me in connection with the use of any facilities or services.

2. I understand that it is my responsibility to consult with my primary care physician prior to participating in Breathwork Activities. I attest that I have undergone an evaluation with my primary care physician, or I certify that I am in good health physically, mentally, psychologically and emotionally, and fully understand and acknowledge that if I am not in good health, I will not be permitted to partake in Breathwork Activities. I understand that Breathwork Activities are not advised for persons with a history of the following, but not limited to: use of major medications, mental illness, seizure disorders, aneurysms, cardiovascular disease, including angina or heart attack, high blood pressure, glaucoma, retinal detachment, osteoporosis, significant recent physical injuries or surgery.
3. Breathwork can result in intense physical and emotional release, and is not a substitute for counseling, psychotherapy, psychoanalysis, mental health care or substance abuse treatment. I will not use Breathwork Activities in place of any form of therapy.
4. I understand that pregnant women are not advised to practice any Breathwork Activity without first consulting and getting approval from their primary care physician. I understand that persons with asthma are advised to consult with their primary care physician before engaging in any Breathwork Activity and if permitted to participate, to bring their inhaler.
5. These services are provided "as is," without warranty of any kind, either expressed or implied, including without limitation any warranty for information services provided through or in connection with the service. This service is requested at my own choice and with inherent singular responsibility.
6. I accept full responsibility and waive all rights to liability or any claims against Beth Larsen Coaching,  LLC and Instructor. I, on behalf of myself, my heirs, personal representatives, or assigns hereby forever release, waive, discharge and covenant not to sue Beth Larsen Coaching, LLC and Instructor, for any injury, harm, death or other claim caused by either negligence or other acts or omissions. I understand and agree that this Release 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 waive and relinquish any and all rights under any law or statute to the contrary.

   7.  I understand that I have given up substantial rights by signing this Release and sign it freely and voluntarily without any inducement. I hereby release, indemnify, defend, and hold harmless Beth Larsen Coaching,  LLC and Instructor against all claims, damages, costs and expenses (including attorney fees), including without limitation those arising out of the alleged sole negligence of Beth Larsen Coaching,  LLC or Instructor. If any portion of this Release is found to be unenforceable, illegal, or contrary to public policy by a court of competent jurisdiction, I agree that this Release shall remain in full force and effect except for such provision or part of any such provision held to be unenforceable.

   By checking this box, I attest that I am eighteen (18) years of age or older. I understand that this Release affects my legal rights, and I have read and understood this Release and all its contents, and I voluntarily agree to the terms and conditions stated above.By signing this Release, I acknowledge that if anyone is injured or killed, or if property is damaged, during my participation in Breathwork Activities, I will be found by a court of law to have waived all right to maintain suit against Beth Larsen Coaching, LLC and Instructor and/or that I will be found to be fully responsible for all attorney fees and all other costs incurred by Beth Larsen Coaching,  LLC or Instructor and/or that I will be found personally liable for any judgment, award or verdict entered against Beth Larsen Coaching, LLC or Instructor. I acknowledge, understand, and agree that this Release, and all of the releases, terms and conditions contained herein, shall apply with equal force and govern any future Breathwork Activity in which I partake with Beth Larsen Coaching, LLC and Instructor, thus obviating the need for me to sign this Release each and every time I partake in such Breathwork Activities.