WAIVER OF LIABILITY AND RELEASE

IN CONSIDERATION OF the risk of injury that exists while participating in the Sacred Medicine Retreat or private facilitated experiences by Vanessa Crites/Vanessa Crites Consulting LLC. (hereinafter the “Activity”); and,

 

IN CONSIDERATION OF my desire to participate in said Activity and being given the right to participate in same;

 

I HEREBY, for myself, my heirs, executors, administrators, assigns, or personal representatives (hereinafter collectively, “Releasor,” “I” or “me”), knowingly and voluntarily enter into this WAIVER AND RELEASE OF LIABILITY and hereby waive any and all rights, claims or causes of action of any kind arising out of my participation in the Activity; and 

 

I HEREBY release and forever discharge Vanessa Crites/Vanessa Crites Consulting LLC (the “Facilitator”), their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns (collectively, “Releasees”), from any physical or psychological injury that I may suffer as a direct result of my participation in the aforementioned Activity.

 

I AM AWARE OF THE RISKS ASSOCIATED WITH PARTICIPATING IN THIS ACTIVITY, WHICH MAY INCLUDE, BUT ARE NOT LIMITED TO: PHYSICAL OR PSYCHOLOGICAL INJURY, PAIN, SUFFERING, ILLNESS, TEMPORARY OR PERMANENT DISABILITY (INCLUDING PARALYSIS), ECONOMIC OR EMOTIONAL LOSS, PROPERTY DAMAGE, AND DEATH. I UNDERSTAND THAT THESE INJURIES OR OUTCOMES MAY ARISE FROM MY OWN OR OTHERS’ NEGLIGENCE, CONDITIONS RELATED TO TRAVEL TO AND FROM THE ACTIVITY, OR FROM CONDITIONS AT THE ACTIVITY LOCATION(S). I FURTHER ACKNOWLEDGE THAT ANY INJURIES THAT I SUSTAIN MAY RESULT FROM OR BE COMPOUNDED BY THE ACTIONS, OMISSIONS, OR NEGLIGENCE OF THE FACILITATOR, INCLUDING NEGLIGENT EMERGENCY RESPONSE OR RESCUE OPERATIONS OF THE FACILITATOR. NONETHELESS, I AM VOLUNTARILY PARTICIPATING IN THE AFOREMENTIONED ACTIVITY AND I AM PARTICIPATING IN THE ACTIVITY ENTIRELY AT MY OWN RISK. I ASSUME ALL RELATED RISKS, BOTH KNOWN AND UNKNOWN TO ME, OF MY PARTICIPATION IN THIS ACTIVITY.

 

I HEREBY expressly waive and release any and all claims, now known or hereafter known, against the Releasees on account of physical or psychological injury, disability, pain, suffering, illness, death, or property damage arising or attributable to my participation in the Activities, whether arising out of the negligence of the Facilitator or any Releasees or otherwise. I covenant not to make or bring any such claim against the Facilitator or any other Releasees, and forever release and discharge the Facilitator and all other Releasees from liability under such claims. This waiver and release does not extend to claims for intentional torts or any other liabilities that Georgia law does not permit to be released by agreement.

 

I FURTHER AGREE to indemnify, defend and hold harmless the Releasees against any and all losses, claims, suits or actions of any kind whatsoever for liability, damages, compensation, costs including attorney’s fees, the costs of enforcing any right to indemnification under this Release, and the cost of pursuing any insurance providers, incurred by the Facilitator or otherwise brought by me or anyone on my behalf, as well as arising out of any claim of a third party, related to my participation in the Activity, including any claim related to my own negligence or the negligence of the Facilitator.

 

I FURTHER ACKNOWLEDGE that Releasees are not responsible for errors, omissions, acts or failures to act of any party or entity conducting a specific event or activity on behalf of Releasees. In the event that I should require medical care or treatment, I authorize the Facilitator to provide all emergency medical care deemed necessary, including but not limited to, first aid, CPR, the use of AED’s, emergency medical transport, and sharing of all medical information with medical personnel. I further agree to assume all costs involved and agree to be financially responsible for any costs incurred as a result of such treatment. I am aware and understand that I should carry my own health insurance.

 

I FURTHER ACKNOWLEDGE that this activity may involve a test of a person’s physical and mental limits and may carry with it the potential for death or serious injury. I agree not to participate in the Activity unless I am medically able and I agree to abide by the decision of the Facilitator’s official or agent, regarding my approval to participate in the Activity.

 

I HEREBY ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS “WAIVER AND RELEASE” AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY AND THAT I AM VOLUNTARILY GIVING UP SUBSTANTIAL LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE THE FACILITATOR AND RELEASEES. I EXPRESSLY AGREE TO RELEASE AND DISCHARGE THE FACILITATOR AND ALL OF ITS AFFILIATES, MANAGERS, MEMBERS, AGENTS, ATTORNEYS, STAFF, VOLUNTEERS, HEIRS, REPRESENTATIVES, PREDECESSORS, SUCCESSORS AND ASSIGNS, FROM ANY AND ALL CLAIMS OR CAUSES OF ACTION AND I AGREE TO VOLUNTARILY GIVE UP OR WAIVE ANY RIGHT THAT I OTHERWISE MIGHT HAVE TO BRING A LEGAL ACTION AGAINST THE FACILITATOR FOR PERSONAL INJURY.

 

I FURTHER REPRESENT that I understand the Activity includes the ingestion of natural entheogenic substances, as well as other Amazonian healing medicines such as Kambo and plants such as Hape.

I FURTHER REPRESENT that I have been provided information regarding the contraindication of natural entheogens with certain medications, including but not limited to MAOI’s. I represent that I have read and fully understand the information that was provided to me. I represent that I am not currently taking any of the medications listed in the Welcome Packet, that are contraindicated with natural entheogenic substances, such as those to be consumed as part of the Activity, as defined herein.

I FURTHER REPRESENT that I have been provided information regarding the dangers associated with consuming natural entheogenic substances while suffering from certain medical conditions, both physical, and/or mental/psychological in nature. I represent that I have read and fully understand the information that was provided to me. I represent that I am not currently suffering from any of the medical conditions listed in the intake form.

I FURTHER REPRESENT THAT I HAVE BEEN ABSOLUTELY TRUTHFUL AND HONEST IN DISCLOSING MY CURRENT MEDICATIONS AND PRIOR AND CURRENT MEDICAL HISTORY AND I UNDERSTAND THAT NOT BEING TRUTHFUL AND HONEST REGARDING SAID ITEMS COULD RESULT IN MY PHYSICAL OR PSYCHOLOGICAL INJURY, PAIN, SUFFERING, ILLNESS, TEMPORARY OR PERMANENT DISABILITY (INCLUDING PARALYSIS), ECONOMIC OR EMOTIONAL LOSS, AND DEATH AS A RESULT OF MY PARTICIPATION IN THE ACTIVITY.
 

I FURTHER REPRESENT that I will follow instructions given by the facilitators of the Activity, will not leave the ceremony space until the conclusion of the Activity, and will not disclose the nature of the Activity or the participants in the Activity to any third parties.

 

I FURTHER REPRESENT that I intend to participate in the Activity with the purest of intention of heart, promoting the well-being of all participants.

 

To the extent that statute or case law does not prohibit releases for ordinary negligence, this release is also for such negligence on the part of the Facilitator, its agents, volunteers and employees.

 

I agree that this Release shall be governed for all purposes by Georgia law, without regard to any conflict of law principles. This Release supersedes any and all previous oral or written promises or other agreements.

 

In the event that any damage to equipment or facilities occurs as a result of my or my family’s or my agent’s willful actions, neglect or recklessness, I acknowledge and agree to be held liable for any and all costs associated with any such actions or neglect or recklessness.

 

THIS WAIVER AND RELEASE OF LIABILITY SHALL REMAIN IN EFFECT FOR THE DURATION OF MY PARTICIPATION IN THE ACTIVITY, DURING THIS INITIAL AND ALL SUBSEQUENT EVENTS OF PARTICIPATION.
 

 

THIS AGREEMENT was entered into at arm’s length, without duress or coercion, and is to be interpreted as an agreement between two parties of equal bargaining strength. Both Participant and the Facilitator agree that this agreement is clear and unambiguous as to its terms, and that no other evidence shall be used or admitted to alter or explain the terms of this agreement, but that it will be interpreted based on the language in accordance with the purposes for this it is entered into.

 

In the event that any provision contained within this Release of Liability shall be deemed to be severable or invalid, or if any term, condition, phrase or portion of this agreement shall be determined to be unlawful or otherwise unenforceable, the remainder of this agreement shall remain in full force and effect. If a court should find that any provision of this agreement to be invalid and unenforceable, but that by limiting said provision it would become valid and enforceable, then said provision shall be deemed to be written, construed and enforced as so limited.

 

I, THE UNDERSIGNED PARTICIPANT, AFFIRM THAT I AM OF THE AGE OF 18 YEARS OR OLDER, AND THAT I AM FREELY SIGNING THIS AGREEMENT, I CERTIFY THAT I HAVE READ THIS AGREEMENT, THAT I FULLY UNDERSTAND ITS CONTENT AND THAT THIS RELEASE CANNOT BE MODIFIED ORALLY. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND THAT I AM SIGNING IT OF MY OWN FREE WILL.