Guided Warrior LLC

Participant Waiver
& Informed Consent

Holotropic Breathwork, Sound Bath & Meditation Session

Please read this document carefully and in full before signing. It describes the nature of the session, the experiences you may encounter, the risks involved, and your rights as a participant. Signing indicates that you have read and understood each section and agree to its terms. If you have any questions, please contact us before attending.

Section 01

Description of the Session

This session is a guided, multi-phase somatic experience lasting approximately two and a half hours. It is facilitated by Guided Warrior LLC and takes place at Mipha Melodies, 5253 Stevens Creek Blvd, Santa Clara, CA 95051.

The session consists of four sequential phases: optional preparatory movement and stretching; holotropic breathwork (continuous accelerated breathing to activate non-ordinary states of consciousness); a sound bath using singing bowls and vibrational instruments; and a closing guided Yoga Nidra meditation.

This session is designed as a complete experience. All phases following the optional stretching are required for the safety and integrity of the process. Participants are expected to remain for the full duration.

Section 02

Nature of Holotropic Breathwork

Holotropic breathwork involves sustained, continuous breathing at a rate deeper and faster than normal resting breath. This intentionally alters blood CO₂ levels, producing a state called respiratory alkalosis, which may create temporary physiological and psychological effects including altered states of consciousness.

This is a legitimate, well-documented therapeutic practice developed by psychiatrist Stanislav Grof. It is not a medical treatment and is not intended to diagnose, treat, or cure any condition. It is an experiential modality for self-exploration and emotional processing.

Section 03

Assumption of Risk: Possible Experiences

I understand that participation in this session involves the possibility of the following experiences, all of which are normal, recognized, and typically transient:

Breathwork Tingling or numbness in the hands, face, or feet (paresthesia); involuntary muscle cramping or tetany particularly in the hands; lightheadedness or dizziness; temporary changes in blood pressure; intense emotional release including crying, laughter, or sounds; involuntary body movement; visual imagery or altered perception with eyes closed; feelings of euphoria, fear, grief, or profound stillness; temporary disorientation following the session.

Sound Bath Sensitivity to certain frequencies or volumes; emotional shifts; physical vibration sensations; deep relaxation that may feel unfamiliar or temporarily disorienting.

Meditation Unusual states of awareness; surfacing of memories or emotions; physical restlessness; difficulty returning to ordinary waking consciousness immediately following the session.

Movement Mild muscle soreness or discomfort associated with stretching; risks typical of voluntary physical movement including muscle strain.

Integration In the days following the session, emotional sensitivity, vivid dreaming, or continued processing of material that surfaced during the session may occur. This is a normal part of the process and is not a sign of harm.

I voluntarily assume all such risks and understand that it is my responsibility to monitor my own physical and mental condition and to communicate with the facilitator if I need support.

Section 04

Medical Representations & Contraindications

I represent that I am in sufficient physical and mental health to participate in this session. I understand that holotropic breathwork is contraindicated, meaning it may be inappropriate or require modification, for individuals with any of the following conditions:

Do Not Attend Without Prior Consultation If You Have:

Cardiovascular disease or heart conditions

Uncontrolled high blood pressure

History of epilepsy or seizures

Current pregnancy

Glaucoma or retinal detachment

Recent surgery or significant injury

History of psychosis or schizophrenia

Active bipolar disorder (acute phase)

Severe panic disorder

Pacemaker or implanted cardiac device

Severe PTSD without professional support

Any condition affecting respiratory function

I agree to contact Guided Warrior LLC at GuidedWarriorLLC@gmail.com prior to attending if any of the above apply to me. I understand that a modified practice may be available for some conditions and that my safety is the priority.

I have either consulted a physician regarding my ability to participate, or I have independently determined based on my own knowledge of my health that no such consultation is necessary.

Section 05

Participant Acknowledgments

By signing this waiver I specifically acknowledge and agree to the following:

I understand that this session involves active, sustained breathwork and is not a passive experience. I commit to remaining for the full duration. I understand that the altered states produced during this session may be intense, and that I am responsible for communicating with the facilitator if I require support. I will not consume alcohol or cannabis within 24 hours before the session, and will not arrive under the influence of any substance that may impair my participation. I understand that I should not drive immediately following the session and will allow adequate time before operating a vehicle. I understand that this session is not a substitute for medical or psychological treatment and that the facilitator is not a licensed therapist, physician, or medical provider in the context of this session. I will inform the facilitator before the session of any health conditions, medications, or circumstances that may affect my participation. I respect the privacy and experience of other participants and understand that what occurs in the session space is confidential.

Section 06

Release & Indemnification

In consideration of being permitted to participate in this session, I, for myself and my heirs, executors, administrators, and assigns, hereby release, waive, discharge, and covenant not to sue Guided Warrior LLC, its members, facilitators, contractors, and the venue Mipha Melodies, from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by me during or following my participation in this session, whether caused by negligence or otherwise.

I agree to indemnify and hold harmless Guided Warrior LLC from any loss, liability, damage, or cost they may incur as a result of my participation, including reasonable attorney's fees.

Section 07

Consent to Emergency Treatment

I consent to receive any emergency medical treatment deemed necessary by the facilitator or emergency responders in the event of injury, illness, or accident during or immediately following this session. I understand that I or my designated emergency contact will be notified as soon as practicable.

Section 08

Photography & Media Consent

Guided Warrior LLC may occasionally photograph or record sessions for educational or promotional purposes. No recording will capture identifiable participants without explicit consent.

Complete Your Registration

First Name *

Last Name *

Email Address *

Phone Number

Session Date *

First Time Attending?

Health Notes (Optional)

Emergency Contact Name & Phone

Photography & Media Consent *

I consent to photography and recording for promotional use I do not consent

I have read this waiver in its entirety and agree to all terms. I understand this is a legally binding document.

By entering my full name and today's date below, I confirm that I have read this waiver in its entirety, that I understand and agree to all of its terms, that I am 18 years of age or older, and that I am signing voluntarily and of my own free will.

Full Legal Name (Electronic Signature) *

Date *

Participant Waiver& Informed Consent