Breathwork Participation Waiver & Informed Consent

Alexandra Breathwork or Grounded in Color
Last updated: December 27, 2025

By registering for or participating in any breathwork session, workshop, or event offered by Alexandra Breathwork or Grounded in Color, I acknowledge and agree to the following:

Nature of Breathwork

I understand that breathwork is a somatic practice that may involve conscious breathing, guided awareness, and body-based techniques intended to support nervous system regulation and well-being.

I acknowledge that breathwork:

Is not therapy, counseling, or medical treatment
Does not replace care from licensed medical or mental health professionals
Does not establish a therapist-client relationship

Personal Responsibility

I understand that participation is voluntary and that I am responsible for my own physical, emotional, and mental well-being before, during, and after each session.

I agree to:

Listen to my body and nervous system
Modify, pause, or stop participation at any time
Participate at a pace that feels safe and appropriate for me

I understand that I may choose to step away or leave a session at any point without explanation.

Potential Risks & Responses

I acknowledge that breathwork may bring up physical sensations, emotions, memories, or internal experiences, including but not limited to lightheadedness, tingling, emotional release, or fatigue.

I understand that these responses vary from person to person and session to session.

Medical & Mental Health Considerations

I affirm that I have disclosed (or chosen not to disclose) any relevant medical or mental health conditions to the best of my ability.

I understand that if I have concerns including (but not limited to) cardiovascular conditions, respiratory issues, pregnancy, epilepsy, panic disorders, severe mental health conditions, or recent trauma, I am encouraged to consult a qualified healthcare professional before participating.

Closed & Group Spaces

I understand that some offerings, including Held, are closed or defined group spaces.

While respect and confidentiality are strongly encouraged, I acknowledge that confidentiality in group settings cannot be guaranteed. I agree to respect the privacy, boundaries, and experiences of other participants.

I agree not to record, share, or distribute session content without explicit permission.

Release of Liability

To the fullest extent permitted by law, I release and hold harmless Alexandra Breathwork, its facilitator(s), and any associated parties from any and all claims, liabilities, demands, or causes of action arising out of or related to my participation, including physical, emotional, or psychological responses.

Consent

By participating, I confirm that:

I have read and understood this waiver
I agree to participate voluntarily
I accept full responsibility for my experience

Acknowledgment

☐ I have read, understood, and agree to this Breathwork Participation Waiver & Informed Consent.

☐ I understand that breathwork is not therapy or medical treatment and that I participate voluntarily, at my own pace, and at my own responsibility. I agree to the Breathwork Participation Waiver & Informed Consent.

Name: __________________________
Date: __________________________