Chakra Breathing® Participation & Liability Waiver
Assumption of Risk, Release of Liability, and Informed Consent Agreement
By signing below, I acknowledge and agree to the following:
1. Voluntary Participation
I understand that I am voluntarily participating in Chakra Breathing® sessions, classes, workshops, facilitator training, retreats, and related activities (collectively referred to as “Services”) offered by Alana Lee.
I acknowledge that I am choosing to participate of my own free will and at my own risk.
2. Nature of the Practice
I understand that Chakra Breathing® may include:
Conscious connected breathwork
Somatic awareness practices
Guided meditation
Emotional release processes
Chakra-based visualization
Movement, yoga, or qigong
Nervous system regulation techniques
Group sharing
I understand that breathwork can be physically, mentally, and emotionally intense and may result in altered states of consciousness, physical sensations, emotional release, or surfacing of past memories.
3. Medical Disclaimer
I understand that Chakra Breathing® is not a substitute for medical, psychological, or psychiatric treatment.
I confirm that:
I am physically and mentally capable of participating, OR
I am under the care of a licensed healthcare provider and have received clearance to participate.
I understand it is my responsibility to consult a physician before participating if I have any concerns.
4. Contraindications
I understand that breathwork may not be appropriate for individuals with certain conditions, including but not limited to:
Pregnancy - Do NOT do any breath holds while pregnant, rhythmic breathing and long slow breaths are safe.
Cardiovascular disease or high blood pressure
History of aneurysms
Seizure disorders or epilepsy
Severe asthma or respiratory conditions
Glaucoma or retinal detachment
Recent surgery or significant physical injury
Severe PTSD or trauma without therapeutic support
Bipolar disorder, schizophrenia, or psychosis
Use of medications that alter brain chemistry
Any condition that could be worsened by intense breathing or emotional release
I affirm that I do not have any medical or psychiatric condition that would make participation unsafe, OR I have consulted with and received clearance from my healthcare provider.
5. Personal Responsibility
I accept full responsibility for:
Monitoring my own physical and emotional well-being
Modifying or stopping participation at any time
Seeking appropriate medical or psychological care if needed
I understand that I may choose to stop participating at any point.
6. Release of Liability
To the fullest extent permitted by law, I release and hold harmless Alana Lee, Chakra Breathing®, its affiliates, assistants, and event hosts from any and all claims, demands, damages, or causes of action arising out of or related to my participation in the Services.
This includes, but is not limited to:
Physical injury
Emotional distress
Psychological responses
Loss or damage of personal property
7. No Guarantees
I understand that results vary and no specific outcomes are guaranteed.
8. Confidentiality
I agree to respect the confidentiality of other participants and not disclose personal information shared within sessions or trainings.