Breathwork & Movement Participation Waiver

A trauma‑aware, culturally grounded consent agreement for online and in‑person sessions.

Introduction & Purpose

Breathwork and movement sessions with movewithme.withjuanita may include breathwork practices, mobility work, strength‑based movement, grounding techniques, and nervous system regulation. These practices are designed to support emotional regulation, somatic awareness, and embodied wellbeing.

Participation is always voluntary. You may pause, modify, or stop at any time.

This waiver ensures you understand the nature of these practices and participate with full awareness and choice.

Nature of Breathwork & Movement

Breathwork and movement may involve:
• changes in breathing patterns
• increased oxygen or carbon dioxide levels
• physical sensations such as tingling, temperature shifts, light‑headedness, or muscle activation
• emotional responses such as release, overwhelm, or unexpected feelings

These responses are natural and vary from person to person.

Breathwork and movement are not substitutes for medical, psychological, or therapeutic treatment.

Health Conditions & Contraindications

Breathwork and movement may not be suitable for individuals with certain medical or psychological conditions.

Please disclose if you have any of the following:
• cardiovascular conditions (including high or low blood pressure)
• respiratory conditions (asthma, COPD, chronic breathing issues)
• epilepsy or seizure history
• pregnancy
• recent surgery or injury
• severe anxiety, panic disorder, or dissociation
• history of psychosis or schizophrenia
• any condition that may be affected by changes in breathing or physical movement

Failure to disclose relevant conditions may increase your personal risk.

Participant Responsibility

By participating, you agree to:
• take responsibility for your own physical and emotional wellbeing
• work within your own limits
• stop immediately if you feel dizzy, faint, distressed, or unwell
• notify the facilitator of any concerns
• seek medical or psychological support if needed after the session

You understand that you may choose to keep your camera on or off during online sessions.

Facilitator Scope of Practice

movewithme.withjuanita provides trauma‑aware, culturally grounded breathwork and movement facilitation.

The facilitator:
• does not diagnose, treat, or cure medical or psychological conditions
• does not provide therapy, counselling, or crisis support
• may offer grounding, regulation, and movement‑based support
• may pause or modify the session if safety concerns arise

All breathwork facilitators working under movewithme.withjuanita hold appropriate and current certification.

Online Participation Safety

For online sessions, you agree to:
• ensure a safe, clear space free from hazards
• use stable equipment and internet
• position your device securely
• avoid practising breathwork or movement while driving or operating machinery

movewithme.withjuanita is not liable for injuries occurring in home or personal environments.

Liability Waiver

By participating in breathwork and movement sessions, you acknowledge and agree that:
• you understand the nature of these practices and their potential risks
• you participate voluntarily and at your own risk
• you have disclosed all relevant health conditions
• you are responsible for your own physical and emotional wellbeing
• movewithme.withjuanita is not liable for:
- injuries arising from participation
- emotional responses triggered during sessions
- undisclosed health conditions
- online/home‑based environment hazards
- misuse of instructions or unsafe personal choices

To the extent permitted by Australian law, you release movewithme.withjuanita and its facilitator from any claims, demands, or liability arising from your participation.

Consent to Participate

By submitting this form, you confirm that:
• you have read and understood this Breathwork + Movement Waiver
• you are participating voluntarily
• you accept all risks associated with participation
• you agree to the terms outlined above

Submission of this form constitutes acceptance of this agreement.