Assumption of Risk, Release & Informed Consent
I acknowledge that participation in Luminosa, Emergence, or any retreat or ceremony hosted by Monica Hickey/Guerreiro involving psilocybin (the “Ceremony”) may involve physical, mental, emotional, or spiritual intensity, discomfort, or unexpected effects.
I confirm that I am at least 18 years of age and am voluntarily choosing to participate.
Nature of the Ceremony
I understand that participation in this Ceremony may include the ingestion of psilocybin (a naturally occurring psychoactive mushroom/entheogen).
I acknowledge that I have been informed of the intended purpose of the Ceremony and the possible physical, emotional, and psychological effects. I confirm that I am choosing to participate of my own free will following my own research and personal interest.
Medical & Psychological Responsibility
I understand that psilocybin may not be appropriate for individuals with certain medical or psychiatric conditions, including but not limited to a history of psychosis, schizophrenia, bipolar disorder, severe anxiety disorders, or heart conditions.
I confirm that I have disclosed all relevant medical, psychological, and medication information on my intake form. I understand that certain medications (including SSRIs, MAOIs, stimulants, and other prescriptions) may interact with psilocybin.
I accept full responsibility for consulting with a licensed medical professional if I have any uncertainty regarding my eligibility.
Possible Effects
I understand that I may experience:
• Nausea, dizziness, cramping, or physical discomfort
• Emotional intensity or release
• Altered perception or temporary disorientation
• Psychological or spiritual experiences that may feel challenging
I knowingly and voluntarily assume full responsibility for any physical, emotional, or psychological responses that may arise, whether anticipated or unanticipated.
Voluntary Participation & Conduct
I understand that my participation is entirely voluntary. I agree to remain for the duration of the Ceremony unless otherwise directed by facilitators for safety reasons.
I agree to:
• Respect all participants
• Maintain confidentiality and discretion regarding others’ experiences
• Follow the guidance of the facilitators and assistants
• Refrain from judgmental, disruptive, or disrespectful behavior
I understand that unsafe or inappropriate behavior may result in removal from the Ceremony without refund.
Transportation
I agree to arrange safe transportation to and from Lokah Yoga and understand that I may not operate a vehicle following the Ceremony.
No Medical Claims
I understand that the Ceremony is not a substitute for medical, psychiatric, or psychological care. No claims are made regarding the curing of illness or the nature of any spiritual experience, which I understand to be personal and subjective.
Release of Liability
I knowingly and voluntarily assume full responsibility for all risks associated with my participation.
I hereby release, waive, discharge, and hold harmless:
Monica Hickey/Guerreiro, Lokah Yoga, assistant guides, helpers, associates, volunteers, staff, agents, employees, successors, heirs, and other participants from any and all claims, liabilities, demands, damages, or causes of action arising from my participation.
I further agree to indemnify and defend them from any claims or actions brought as a result of my participation.
This agreement is binding upon myself, my heirs, executors, administrators, and assigns.
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