New Waiver Form Sept 2023
For participation in Conscious Connected Breathwork session
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Email address *

For the purposes of this Release and Waiver, the term “Releasee” shall be defined as follows:

Name of Practitioner: Claryn Nicholas, herein referred to as "the Releasee."

Name of company: Claryn Nicholas Holistic Health.

I, referred to as "the Releasor," hereby acknowledge and comprehend that the discussions, consultations, conscious connected breathwork, yoga, and coaching session(s) I participate in with the Releasee entail the following:

a) They are not intended to serve as a replacement for any existing relationship I have with my medical doctor and/or primary healthcare provider(s).

b) They are not intended to offer medical advice or serve as a substitute for medical care.

c) They are not intended to be relied upon for prescriptions, recommendations, diagnosis, or treatment concerning any health problem or disease.

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I acknowledge that during a conscious connected breathwork, yoga, and coaching session, physical touch may be incorporated to assist me in my personal development, and I retain the right to decline such touch by utilising the word 'Stop.'

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I acknowledge that I must inform the facilitator/s if I am currently taking any medications or have any medical conditions, including but not limited to schizophrenia, bipolar disorder, epilepsy, heart conditions, or pregnancy.

Furthermore, I understand that despite being accepted as a participant, I bear full responsibility for any outcomes resulting from the conscious connected breathwork, yoga, and/or coaching sessions.

I certify that I have sought medical advice regarding any physical, mental, or emotional conditions that might impair my judgment or affect my physical well-being during or after a conscious connected breathwork, yoga, and/or coaching session.

I comprehend and accept the obligation to consult my primary healthcare provider or a medical doctor if I have or suspect I have a health issue.

Claryn Nicholas encourages me to collaborate with my medical doctor and/or primary healthcare provider(s) in making healthcare decisions, based on my own research about the effectiveness of conscious connected breathwork, yoga, and coaching sessions, as well as the significance of diet, exercise, supplementation, stress management, and emotional and mental well-being.

I acknowledge that by engaging in conscious connected breathwork with the Releasee, I am assuming this risk voluntarily.

With this understanding, I willingly endorse this release and waiver.

I, on behalf of myself, my heirs, and my assigns, hereby release the Releasee from any and all actions, causes of action, complaints, claims, damages, costs, and expenses of any nature related to or arising from the discussions, consultations, and/or conscious connected breathwork(s) I have had or may have with the Releasee, now and in perpetuity.

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