SOULS Ceremony Waiver
Indemnification and Release
I, being of lawful age and sound mind, in consideration of being permitted to participate in Amazonian Plant Sacrament (Sacramental Medicine) Ceremony (aka Sacred Ceremony) and related activities and programs run and/or operated by SOULS (Sanctuary of Universal Love & Service) and partake of Amazonian Plant Sacraments administered by SOULS, and/or any organized activities and programming on site or in the region and associated properties of said hosts of SOULS, do WAIVE, RELEASE and DISCHARGE SOULS, its owners, officers, directors, representatives, associates, members, facilitators, volunteers, retreat hosts, and legal representatives of the above noted activity and each of them their owners, officers and employees, from all liability for or by reason of any damage, loss, or injury to my person and property, even injury resulting in the death of the Releasor (myself), which has been or may be sustained in consequence of my (the Releasor) participation in the activities described above or sustained on the grounds and property of the Releasees or during organized programming in regions conducted by the Releasees, and notwithstanding that such damage, loss or injury may have been caused solely or partly by the negligence of the Releasee. I further agree to defend and indemnify them from any claims, suits or demands. I understand that this agreement is binding upon me, my spouse, parents, family, heirs, executors, administrators, agents, and assigns. I also acknowledge that by signing this release, I will be forever prevented from suing or otherwise claiming against the Releasees for any property loss or personal injury that I may sustain while participating in or preparing for the above noted activity or activities.
Agreement to Follow Directions
I have fully read and understand the information that has been provided to me about the Plant Sacrament (aka “Mamacita” or “Madrecita”), its uses, effects, and the appropriate preparations for participating in Sacred Ceremony. I agree to follow all instructions, directions, and requirements as given before, during, and after Sacred Ceremony, by the SOULS team of ministers, facilitators, guardians, guides, and assistants. I have fully read and understand the pre-ceremony dietary requirements that, when followed, will allow the plant medicine to work more deeply and effectively. I am willing to abide by the dietary guidelines and restrictions for at least three to five days prior to Sacred Ceremony, although I am aware that longer dietary cleansing can be beneficial. I understand that the facilitators reserve the right to deny my participation at any time (before, during, or after Sacred Ceremony) if they deem that it would be unsafe for me, or for others, or for any other reason. I agree to remain until the closing of any Sacred Ceremony which I choose to begin (Sacred Ceremony closes after the subsequent sharing circle is complete).
Transparency and Full Disclosure
I hereby confirm that I have answered all the questions in the Application to Participate in Sacred Ceremony (and the included Questionnaire) completely and honestly, and have not withheld any information.
No Duress
I agree and acknowledge that I am under no pressure or duress to sign this Agreement and Release Form, and that I have been given reasonable opportunity to read and review it before signing. I understand that my participation in Sacred Ceremony is purely voluntary. I understand that during the Sacred Ceremony in which I participate, I will ingest an entheogen plant sacrament known as Ayahuasca. This sacrament is a natural extract of plants (Banisteriopsis Caapi and Psychotria Viridis) which grow throughout the Amazon Basin in South America and also in Hawaii. I am aware of its effects, as well as the objectives of taking it within the Sacred Ceremony ritual led by experienced Ayahuasca ceremony leaders. I am attracted to this plant sacrament with the intention of a potential, profound spiritual experience. I understand that the SOULS facilitators, ministers, and other staff make no claim or promise regarding the curing of any illness or the nature of any spiritual experience. I understand that the Sacred Ceremony is personal and sacred to each individual, and that what may occur for one person may not necessarily lead to the same experience in others.
Costs and Fees
I agree to pay for any and all damages to the facility in which my Sacred Ceremony takes place caused by any negligent, reckless, or willful actions by me or my family. I also agree to pay any and all fees related to my participation in Sacred Ceremony as and when specified by SOULS.
Assumption of Risks and Challenges
I hereby acknowledge and voluntarily assume the full risks and responsibilities of my participation in Sacred Ceremony, including the possibility of any physical or other injury, damage or losses, either to myself or caused to others by me during any Sacred Ceremony organized by or held on the property of the facilitators. I understand that the Sacred Ceremony in which I choose to participate may be physically, mentally, emotionally, and/or spiritually demanding. I understand that I may experience dizziness, nausea, or other physical upsets including vomiting and diarrhea. I accept full responsibility for anything that may occur including emotional disturbance, mental disorientation, and any and all possible manifestations of physical, emotional, and mental changes, including mental illness, both during, and after the Ceremony. I acknowledge that I am aware of the risks and potential challenges and benefits of my participation, and I freely choose to enter this process accepting full responsibility for whatever may occur, anticipated or unanticipated.
Physical and Mental Health
My general health, as far as I am aware, is good. I acknowledge that I do not have any physical limitations, medical ailments, physical or mental disabilities or disorders that would limit or prevent me from participating in Sacred Ceremony. If I have any such physical or mental limitations, ailments, disabilities, or disorders that I am aware of, I will inform the Releasee (SOULS) in writing before participating in such activities.
Drugs, Substances, and Supplements
I acknowledge that I have informed SOULS of any and all drugs/medications/pharmaceuticals/substances (including prescriptions, over-the-counter drugs, recreational drugs and substances, and other plant medicines, entheogens, psychedelics, and mind-altering substances) and/or natural supplements that I may currently be taking, plan to take around the time of my participation in SOULS Sacred Ceremony or in the future, or have taken within no less than four three months of the Sacred Ceremony in which I plan to participate. And, if I have taken any of these medications, drugs, supplements, or substances, and SOULS informs me that any of them are contraindicated (should not be combined) with the Plant Sacrament, I will stop taking them exactly when and as advised by SOULS (with the approval and guidance of my personal or prescribing doctor, as necessary), and/or I understand that I may need to postpone my participation in Sacred Ceremony to a later date.
This release contains the entire agreement between the parties to this release, and the terms of this release are contractual and binding.