Health Waiver

I understand that if I am taking any medications or have any medical conditions such as, but not limited to:

  • Schizophrenia,
  • bipolar disorder or psychosis,
  • epilepsy,
  • heart conditions,
  • COPD,
  • delicate pregnancy,
  • high/very low blood pressure with fainting history,
  • PTSD,
  • or recent major surgery

that I must advise the facilitator before the session.

I also understand that even though I have been accepted as a participant, I am responsible for any consequence resulting from any breathwork session that I do with Divine Roots.

Divine Roots is not a substitute for consulting your doctor or medical care provider. In the event of known medical conditions, I certify that I have consulted a health professional regarding any condition (physical, mental or emotional) that could interfere with my judgment, or affect my health in any way during or after the session.

In-person sessions only – I am aware that appropriate touch may be used for the purpose of supporting my wellbeing and comfort.

I have read this waiver and signed the below confirmation that I take full responsibility for my own health and wellbeing.

Health Waiver
I have done Breathwork with Rebecca at least once before
I do not have a heart condition, am newly pregnant, or have been diagnosed with bipolar disorder or schizophrenia
I understand and acknowledge that by participating in this session , I do so at my own risk. Since the session is experiential in nature and the extent of the session’s risks and benefits are not fully known, I agree to assume and accept full complete responsibility for any known and unknown risks associated with my participation in the session, including any physical injury, psychological or emotional effects.