I understand that this session may involve any of the following breathwork practices:

● Conscious connected breathing

● Circular breathing

● Short Breath holds ( less than 30 seconds)

● Slow rhythmic breathing

● Somatic movement and emotional release

During this type of work, your child may experience physical sensations (e.g., tingling, lightheadedness, temperature changes), emotional responses (e.g., crying, anger, joy), or energetic shifts. These are common and can be part of the healing process.*

I understand that breathwork may not be recommended and diagnosis of the following MUST be discussed and disclosed prior to booking:

● High or uncontrolled blood pressure

● Cardiovascular disease or recent heart surgery

● Diagnosed aneurysms

● Epilepsy or history of seizures

● Bipolar disorder, schizophrenia, or psychosis

● Use of some antipsychotic medication

● Severe PTSD

● Recent physical injuries or surgeries

● Pregnancy

● Severe asthma

● Detached retina or glaucoma

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By participating in this breathwork session, I confirm that my child will not under the influence of alcohol, recreational drugs, or any substance that may impair their ability to consent*

 I release and indemnify Asia Jackson and any affiliated facilitators from liability for claims of injury, illness, damage, or distress that may arise during or after the session.

*

By signing below, I confirm that I have read, understood, and agree to the Intake Waiver Participation Agreement and Assumption of Risk outlined above.*