BREATHWORK RELEASE AND WAIVER

For the purposes of this Release and Waiver, the term “Releasees” shall refer to any or all of:

1. Name of Practitioner: Casey Von Iderstein;

2. Name of organization, company or legal entity: Karmic Wellness LLC; and

3. The heirs, assigns, successors, employees, volunteers and/or associates of Casey Von Iderstien and/or Karmic Wellness LLC.

I, (“the Releasor”), understand and acknowledge that the discussions, consultations, and breathwork session(s) I have with the Releasees:

a) are not intended to replace any relationship I have with my medical doctor and/or primary health care provider(s);

b) are not intended to constitute medical advice or any substitution for medical care; and

c) are not intended to be relied on for prescriptions, recommendations, diagnosis or treatment in relation to any health problem or disease.

I understand that if I am taking any medications or have any medical conditions such as, but not being limited to: schizophrenia, bi-polar, epilepsy, heart conditions, or pregnancy, that I must advise the Releasees in writing. I also understand that even though I have been accepted as a participant, I am solely responsible for any consequence resulting from or related to the breathwork session(s) that I take part in including but not limited to any injuries that occur as a result of any negligence.

I certify that I have taken medical advice relating to any physical, mental, or emotional condition that may impair my judgment, or have any effect on my physical health during or after a breathwork session. I understand and acknowledge that I am responsible for consulting my primary health care provider or a medical doctor in the event that I have, or suspect that I may have, a health problem.

I am encouraged by the Releasees to make my health care decisions in partnership with my medical doctor and/or primary health care provider(s) on the basis of my own research regarding the effectiveness of breathwork sessions and the importance of diet, exercise, supplementation, stress management, and emotional and mental work.

I understand and acknowledge that, in undertaking breathwork sessions with any of the Releasees, I am doing so at my own risk. It is with that understanding that I voluntarily execute this Release and Waiver.

I, acting on behalf of myself, my heirs and my assigns, hereby release the Releasees from any actions, causes of action, complaints, claims, damages, costs and expenses of any kind with respect to, or arising out of, any of the discussions, consultations and/or breathwork session(s) I have had or may have with any of the Releasees now and forever.

By:______________________

Printed Name: ____________

Date:___________________