Breathcamp Form Preparing for Your Session Name * First Name Last Name Email * 1. What Breathwork Experience do you have? * None (Please attend our online workshop before Breathcamp) Inspirational Breathing Introductory Workshop Online Inspirational Breathing in-person workshop 1-2-1 with an Inspirational Breathing Practitioner Other - please specify below Other (please tell us about your breathwork experience) 2. Have you had any recent surgery or health problems such as whiplash, a heart condition, a pacemaker, breathing difficulties, if you are pregnant, please give details here: 3. Do you take medication or self medicate? If so, please give brief details: 4. Do you have any particular emotions which predominate in your life, or any unresolved trauma that you are aware of? 5. Where do you typically hold tension in your body? 6. Do you have any details of your birth that were significant e.g cord around neck, forceps delivery, separated from your mother? Preparing for you Session * Yes, I have read Preparing for you Session and the Breathwork Terms and Conditions (see website footer for link) * I consent to Inspirational Breathing collecting, storing, and processing my personal information for the purpose of providing breathwork workshop services. This includes using my data to manage my workshop registration, communicate important information about the workshop, and ensure my safe participation. I understand that I can withdraw my consent at any time by contacting life@inspirationalbreathing.com. For more information on how we handle your data, please see our Privacy Policy. Thank you!