Breathwork Consent Form

I understand that any physical activity contains risks and agree not to hold Charlotte Spillane liable for any injury, accidental or otherwise.

I certify that I am not suffering from any physical injury which I have not disclosed.

I confirm that there is no reason why a medical doctor would recommend that I do not participate in the breathwork session.

I confirm that I have read the GDPR Terms and Conditions and am aware of how my data will be processed and stored:
YesNo

GP Practice:

Medication details:

I am happy for you to contact my GP:
YesNo

Your name:

Your email:

Date:

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