The Guided Circle - Informed Consent, Waiver & Release of Liability

Applicable in the Province of Ontario, Canada
www.theguidedcircle.com | @theguidedcircle | 416-738-4919

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Thank you for choosing to participate in a session or class facilitated by The Guided Circle, which may include modalities such as Elemental Rhythm Breathwork, Reiki, Craniosacral Therapy, Therapeutic Touch, Touch for Health, Reflexology, and other holistic practices. These sessions are designed to support relaxation, energy balance, personal growth, and transformation.

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We invite you to enter into this experience with curiosity and respect for your own boundaries. Some of these modalities, particularly advanced breathwork, have the potential to create powerful emotional, physical, and energetic shifts. Please read the following information carefully before participating.

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General Disclaimer

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By signing this form, you acknowledge and agree that:

• You are voluntarily participating in a session that may involve physical, emotional, and energetic practices.

• You understand that Reiki, Craniosacral Therapy, Therapeutic Touch, Touch for Health, and Reflexology are gentle, hands-on or hands-off energy-based modalities used for stress reduction and relaxation.

• These modalities do not diagnose, treat, or cure any medical or psychological condition, nor do they replace the advice or care of a licensed medical professional.

• It is recommended that you continue to consult with your physician or healthcare provider for any medical or psychological concerns.

• These therapies are complementary to other healthcare approaches and are meant to support the body’s natural ability to heal through relaxation and energetic alignment.

Breathwork Specific Disclaimer

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Elemental Rhythm Breathwork is a powerful modality that may involve physical and emotional release. While it is generally considered safe and low-risk, it is not suitable for everyone. Potential temporary sensations may include:

• Lightheadedness or dizziness

• Tingling sensations

• Emotional catharsis

• Muscle tightness or tetany

• Temporary loss of consciousness (rare)

Precautions must be taken to ensure safety. Therefore:

• Breathwork must not be practiced while driving, swimming, or operating heavy machinery.

• Practice only in safe, supported spaces where you are lying or seated securely.

• Always inform the facilitator of any health concerns before beginning.

Contraindications for Breathwork

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Breathwork is not recommended for individuals with the following conditions unless explicitly approved by a medical doctor:

• Cardiovascular issues (e.g., heart attack, angina, high blood pressure)

• Glaucoma or retinal detachment

• Aneurysms (personal or family history)

• Osteoporosis or recent surgery/injury

• Epilepsy or seizure disorders

• Severe mental health disorders

• Use of major medications

• Pregnancy (without medical consent)

• Asthma (unless inhaler is present and approval has been given by a physician)

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Waiver & Release of Liability

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By signing below:

• I acknowledge that I have read and understand the potential risks and benefits of participating in these holistic wellness practices.

• I affirm that I am participating voluntarily and assume full responsibility for my physical, emotional, and mental well-being.

• I hereby release and forever discharge The Guided Circle, Revive My Body, 1343109 ONT. Inc, Alex McLeish-Deuters, The Ki Room, Heather LaFontaine from any and all liability, claims, demands, actions, or causes of action arising out of or related to any injury, loss, or damage that may occur in connection with participation. 

Acknowledgment 

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By signing below, I confirm that I have read, understood, and voluntarily agree to the terms above. I affirm that I am of legal age in Ontario and have consulted with my healthcare provider where appropriate. This release form is valid for 1 year from the date of signing. Below if an * is present the field is mandatory to complete