BODYWORK LIABILITY WAIVER
IN CONSIDERATION OF MY PARTICIPATION IN BODYWORK AND THE SERVICES OF HEALTHY HABITS BY MARTA, LLC AND ANY OTHER PERSONS OR ENTITY ACTING IN ANY CAPACITY ON ITS BEHALF, (COLLECTIVELY REFFERED TO AS “COMPANY”), I, THE UNDERSIGNED PARTICIPANT, ON BEHALF OF MYSLEF, MY HEIRS, REPRESENTATIVES AND SSIGNS, HEREBY AGREE TO RELASE, WAIVE, DISCHARHE AND COVENANT NOT TO SUE COMPANY AS FOLLOWS:
#1: VOLUNTARY PARTICIPATION:
MY PARTICIPTION IN THIS BREATHWORK SESSION IS ENTIRELY VOLUNTARY, AND I HAVE CHOSEN TO PARTICIPATE OF MY OWN FREE WILL.
I TAKE FULL RESPONISBILITY FOR MY OWN HEEALTH AND WELL-BEING DURING THE BREATHWORK SESSION. I AGREE TO FOLLOW THE INSTRUCTIONS AND GUIDANCE PROVIDED BY THE COACH DURING THE BREATHWORK SESSION TO THE BEST OF MY ABILITIES. I UNDERSTAND THAT I HAVE THE RIGHT TO MODIFY OR DISCONTINUE ANY TECHNIQUE OR EXERCISE AT ANY TIME.
#2: HEALTH AND MEDICAL CONDITIONS:
I AFFIRM THAT I AM IN GOOD HEALTH AND DO NOT HAVE ANY MEDICAL OR PSYCHOLOGICAL CONDITIONS THAT WOULD MAKE PARTICIPATION IN THE BREATHWORK SESSION INADVISABLE. I HAVE CONSULTED WITH A MEDICAL PROFESSIONAL IF I HAVE ANY CONCERNS ABOUT MY ABILITY TO PARTICIPATE IN BREATHWORK. IF I ANSWER “YES’TO ONE OR MORE OF THE FOLLOWING CONDITIONS, I MUST CONSULT WITH MY PHYSICIAN BEFORE ENGAGING IN BREATHWORK: CARDIOVASCULAR DISEASE, ANGINA, HEART ATTACK, HIGH BLOOD PRESSURE, GLAUCOMA, RETINAL DETACHMENT, OSTEOPOROSIS, RECENT INJURY OR SURGERY, ANY CONDITION FOR WHICH I TAKE REGULAR MEDICATION, HISTORY OF PANIC ATTACKS, PSYCHOSIS, AND DISTURBANCES, SEVERE MENTAL ILLNESS, SEIXURE DISORDERS, FAMILY HISTORY OF ANEURYSMS, FREQUENTS DIZINESS OR VERTIGO, OR IF I AM PREGNANT
- IF I HAVE ANY PRE-EXISTING MEDICAL CONDITIONS OR IF I AM PREGNANT, I UNDERSTAND THAT MY PARTICIPATION IN BREATHWORK MAY POSE ADDITIONAL RISKS TO MY HEALTH, WHICH I HAVE CONSIDERED AND DISCUSSED WITH A MEDICAL PROFESSIONAL
#3: ASSUMPTION OF RISKS:
I ACKNOWLEDGE THAT THERE ARE INHERENT RISKS ASSOCIATED WITH THE PRACTISE OF BREATHWORK, ICLUDING BUT NOT LIMITED TO CHANGES IN EMOTIONAL STATE, PHYSICAL SENSATIONS, AND ALTERED STATES OF CONSCIOUSNESS. I AM VOLUNTARILY ASSUMING ALL RISKS ASSOCIATED WITH THE BREATHWORK SESSION.
- CHANGES IN EMOTIONAL STATE: I UNDERSTAND THAT BREATHWORK MAY LEAD TO INTENSE EMOTIONAL EXPIERENCES, INCLUDING BUT NOT LIMITED TO JOY, SADNESS, ANGER, AND ANXIETY. THESE MOTIONAL CHANGES CAN BE UNPREDICTABLE AND MAY CONTINUE BEYOND THE SESSION.
- PHYSICAL SENSATIONS: I ANCKNOWLEDGE THAT DURING BREATHWORK, I MAY EXPERIENCE PHYSICAL SENSATIONS SUCH AS TINGLING, MUSCLE CONTRACTIOBS, OR LIGHTHEADEDNESS
- ALTERED STATES OF CONSCIOUSNESS: BREATHWORK MAY INDUCE ALTERED STATES OF CONSCIOUSNESS, INCLUDING FEELINGS OF DISCONNECTION FROM REALITY, TIME DISTORTION, OR HALLUCINATORY EXPERIENCES.
- POTENTAIL PSYCHOLOGICAL EFFECTS: I AM AWARE THAT BREATHWORK MAY SURFACE BURIED MEMORIES OR EMOTIONS, POTENTIALLY LEADING TO PSYCHOLOGICAL DISCOMFORT, ANXIETY, OR DISTRESS.
- HYPERVENTILATION: THE DEEP AND INTENTIONAL BREATHING INVOLVED IN BREATHWORK MAY LEAD TO HYPERVENTILATION, WHICH CAN RESULT IN DIZZINESSH, SHORTNESS OF BREATH, OR TINGILING IN EXTREMITIES. yPHYSICAL EXHAUSTION: THE BREATHWORK SESSION BAY BE PHYSICALLY DEMANDING, AND I MAY EXPIERENCE PHYSICAL EXHAUSTION.
- PAIN AND DISCOMFORT: IF I EXPIERENCE ANY PAIN OR ISCOMFORT DURING THE BODYWOR, I WILL IMMEDIATELY COMMUNICATE THAT TO THE PRACTITIONER SO THE TREATMENT MAY BE ADJUSTED. I AGREE NOT TO HOLD HEALTHY HABITS BY MARTA LLC RESPONSIBLE FOR ANY PAIN OR DISCOMFORT I EXPIERENCE DURING OR AFTER THE SESSION.
- STRESS REDUCTION AND RELAXATION: I ACKNOWLEDGE THAT BODYWORK IS PROVIDED FOR STRESS REDUCTION, RELAXATION, RELIEF FROM MUSCULAR TENSION AND IMPROVEMENT OF CIRCULATION AND ENERGY FLOW.
- EXAMINATION: I ACKNOWLEDGE AND AGREE THAT BODYWORK IS NOT INTENDED AS A SUBSTITUTE FOR EXAMINATION, DIAGNOSIS, TREATMENT, OR INDIVIDUALIZED CONSULTATION WITH A HEALTHC ARE OR MENTAL HEALTH PROFESSIONAL WHO CAN REVIEW AND ADVICE ME ON MY SPECIFIC SITUATION.
I ACKNOWLEDGE AND AGREE THAT I HAVE BEEN ADVISED TO SEE A LICENSED MEDICAL PROFESSIONAL FOR ANY PHYSICAL OR MENTAL HEALTH CONDITIONS I MAY HAVE.
BECAUSE BODYWORK IS CONTRAINDICATED UNDER CERTAIN CONDITIONS, I AFFIRM THAT I HAVE NOTIFIED THE PRACTITIONER OF ALL MY KNOWN MEDICAL CONDITIONS AND INJURES AND I HAVE ANSWERED ALL QUESTIONS HONESTLY. I FURTHER AFREE TO INFORM THE PRACTITIONER OF ANY CHANGES IN MY HEALTH OR MEDICAL CONDITION. I ACKNOWLEDGE AND AGREE THAT THERE SHALL BE NO LIABILITY ON THE PRACTITIONER’S PART DUE TO MY FORGETTING TO RELAY ANY PERTINENT INFORMATION.
I ACKNOWLDGE AND AGREE THAT ALL BODYWORK IS ENTIRELY THERAPEUTIC AND NON-SEXUAL IN NATURE.
I ACKNOWLEDGE AND AGREE THAT PARTICIPATION IN BODYWORK INVOLVES CERTAIN INHERENT RISKS AND I ACKNOWLEDGE AND AGREE THAT THESE RISKS CANNOCT BE ELIMINATED REGRDLESS OF TGE CARE TAKEN TO AVOID THEM. I EXPLICITLY STATE THAT MY PARTICIPATION IS VOLUNTARY, AND I VOLUNTARILY AGREE TO ASSUME ALL OF THE RISKS AND ACCEPT SOLE RESPONISBILITY FOR ANY NJURY TO MYSLEF INCLUDING, BUT NOT LIMITED TO, PERSONAL INJURY, ILNESS, DEATH, DISABILITY, DAMAGE, LOSS, CLAIM, OR EXPENSE, OF ANY KIND, ARISING FROM PARTICIPATION IN THE BODYWORK.
#4: RESPONISIBILITY FOR PERSONAL PROPERTY:
I AM SOLELELY RESPONSIBLE FOR THE SAFETY AND SECURITY OF MY PERSONAL BELONGINGS DURING THE BREATHWORK SESSION, AND I UNDERSTAND THAT HEALTHY HABITS BY MARTA, LLC IS NOT RESPONSIBLE FOR ANY LOSS OR DAMAGE TO PERSONAL PROPERTY.
#5: WAIVER OF LIABILITY AND RELEASE:
ON MY BEHALF AND MY HEIRS, REPRESENTATIVES AND ASSIGNS, I HEREBY RELASE AND FORECHER DISCHARGE COMPANY FROM LIABILITY FROM ANY AND ALL CLAIMS RSULTING IN PERSONAL INJURY, ILLNESS, DEATH, DISIABILITY, DAMAGE, LOSS, CLAIM, OR EXPENSE, OF ANY KIND ARISING FROM MY PARTICIPATION IN THE BODYWORK, WHETHER OR NOT CAUSED BY THEIR NEGLIGENCE, FAILURE TO ACT OR OTHER ACTS. I AGREE NOT TO SUE OR MAKE A CLAIM AGAINST THE COMPANY.
#6: INDEMNIFICATION AND HOLD HARMLESS:
I AGREE TO INDEMNIFY, WARRANT, DEFEND AND HOLD COMPANY HARMLESS FROM ANY ALL CLAIMS, LEGAL ACTIONS, LIABILITIES, DEMANDS, EXPENSES, DAMAGES AND COSTS, INCLUDING ATTORNEY’S FEES, THAT ARE CONNECTED IN ANY WAY TO PARTICIPATION IN THE BODYWORK. THIS INCLUDES, BUT IS NOT LIMITED TO, CLAIMS FOR PERSONAL INJURY, ILLNESS, DEATH, DISABILITY, DAMAHE, LOSS, CLAIM, OR EXPENSE, OF ANY KIND, REGARDLESS OR ENTITY AT FAULT. I FURTHER AGREE TO REIMBURSE COMPANY FOR ANY AND ALL EXPENSESINCURRED BECAUSE OF ANY SUCH CLAIMS MADE AGAINST THEM, INCLUDING ANY APPEALS. IN THE EVENT OF MY DEATH OR DISABILITY, THESE TERMS WILL BE BINDING ON MY ESTATE, HEIRS, REPRESENTATIVES AND ASSIGNS.
#7 GOVERNANCE AND SEVERABILITY:
THIS BODYWORK LIABILITY WAIVER SHALL BE CONSTRUCTED IN ACCORDANCE WITH, AND GOVERNED BY, THE LAWS OF THE STATE OF DISTRICT OF COLUMBIA AS APPLIED TO CONTRACTS THAT ARE EXECUTED AND PERFORMED ENTIRELY IN DISTRICT OF COLUMBIA, REGARDLESS OF CLIENT’S LOCATION. THE EXCLUSIVE VENUE FOR ANY LEGAL PROCEEDING BASED ON OR ARISING OUT OF THIS AGREEMENT SHALL BE DISTRICT OF COLUMBIA.
I ACKNOWLEDGE AND EXPRESSLY AGREE THAT THIS BODYWORK LIABILITY WAIVER SHALL BE CONSTRUED TO BE AS BROAD AND INCLUSIVE AS IS PERMITTED BY THE LAWS OF THE STATE OF DISTRICT OF COLUMBIA AND IF ANY TERM OF THIS AGREEMENT IS FOUND TO BE INVALID, VOID, OR UNENFORRCEABLE UNDER APPLICABLE LAW, THE OTHER PROVISIONS SHALL REMAIN IN FULL FORCE AND EFFECT, AND SHALL IN NO WAY BE AFFECTED, IMPAIRED, OR INVALIDATED
#8 ACKNOWLEDGMENT:
I ACKNOWLEDGE AND AGREE THAT I HAVE READY THE BODYWORK LIABILITY WAIVER, AND I UNDERSTAND THAT BY SIGNING IT, I AM GIVING UP CERTAIN RIGHTS, INCLUDING BUT NOT LIMITED TO, MY RIGHT TO SUE. I ACKNOWLEDGE AND AGREE THAT I AM AGREEING TO THIS BODYWORK LIABILITY WAIVER FREELY AND VOLUNTARILY. I ACKNOWLEDGE AND AGREE THAT MY ACCEPTANCE OF THIS BODYWORK LIABILITY WAIVER IS INTENDED AS AN UNRESTRICTED AND COMPLETE RELASE OF ALL LIABILITY TO THE FULLEST EXTENT PERMITTED BY THE LAW.