VITAL-KI KAMBO INTAKE, CONSENT & ABILITY WAIVER
I hereby confirm that I have read and fully understood the above information and have answered all the intake medical questions completely and honestly and have not withheld any information.
I acknowledge that participation in the Sacred Kambo Ceremony may involve discomfort and unexpected physical, mental, or emotional upset. In signing this release document, I agree to waive all rights to seek or receive compensation in case of injury, loss, or damage.
Kambo is a healing ritual, named after the secretions of the giant monkey frog, or Phyllomedusa bicolor. The frog secretes the substance as a defense mechanism. Participation in the Sacred Kambo Ceremony includes the application of the frog Kambo secretion known as the "Vaccine of The Forest" in very superficial, small burns points on the top skin (epidermis) of the skin.
I am fully informed of the objectives of the application of this Sacred substance during the ceremony and of its possible effects. I choose to attend this work as a result of my research and interest in ceremonies.
I understand that my participation in this ceremony is entirely voluntary, and I agree to remain at the ceremony to its completion.
I accept that the ceremony shaman, leaders and helpers make NO claim or promise about the curing of illness of any kind, or about the nature of any spiritual experience which I understand is entirely personal. I understand that my participation in the Kambo ceremony may be physically, mentally, emotionally or spiritually demanding.
I understand that I may experience dizziness, nausea, or other physical upsets.
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.
I acknowledge that I am aware of the risks and potential benefits of my participation, and I freely choose to enter this process, accepting full responsibility for whatever may occur whether anticipated or unanticipated.
I understand that the use of any drugs or prescribed medication may interfere or have an adverse effect if ingested prior to, during or after the ceremony.
I acknowledge that the proper dietary guidelines have been provided to me and I take full responsibility for adhering to those guidelines.
I acknowledge that, I will make alternate arrangements for transportation in the event that I may be physically or mentally exhausted and/or disoriented after the ceremony.