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F.A.Y.E RETREAT
Intake form
Have you ever experienced any of the following? (Select all that apply)
Severe anxiety or panic attacks
PTSD or complex trauma
Bipolar disorder
Psychosis or schizophrenia
Heart condition
Epilepsy or seizures
Recent surgery
None of the above
CONSENT & RESPONSIBILITY
I understand that this retreat includes breathwork, movement, embodiment, and energetic practices.
I take full responsibility for my physical, emotional, and psychological wellbeing.
I confirm that I have disclosed all relevant health information.
I understand this is not a substitute for medical or psychological treatment.
I understand the retreat has a no-refund policy.
I agree to follow facilitator guidance and respect group boundaries.
I UNDERSTAND AND AGREE TO ALL OF THE ABOVE
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