• Contraindication and Substance Guideline Understanding and Agreement

  • Things that should be avoided before Kambo. Please read carefully. Mixing Kambo with any of the following could be extremely dangerous.

    • Immune suppressants for auto immune disorders.
    • Slimming or sleeping supplements (including melatonin)
    • Alcohol or drugs 24 hours before and after
    • Do not fast longer than 18 hours 7 days before or after Kambo. This includes juice fast. Clients should have a normal eating pattern leading up to Kambo
    • Sweat lodges, Colonics, enemas, liver flushes or any water based detox should be avoided within 3 days either side of taking Kambo

     

  • Kambo does not generally have unintended adverse effects when administered by a properly trained practitioner and when clients have disclosed any underlying health conditions. You should absolutely not participate in a Kambo treatment if any of the following apply:

    • Have serious heart problems.
    • Are on a no-salt diet (ayahuasca diet)
    • Have Elhers Danlos
    • Have Marfan syndrome
    • Are on medication for low blood pressure.
    • Have had a stroke.
    • Have had a brain hemorrhage.
    • Have an aneurism or blood clots.
    • Lack the mental capacity to make the decision to take Kambo.
    • Have serious mental health problems excluding depression, PTSD and anxiety.
    • Are undergoing chemotherapy, radiotherapy or immunotherapy for 6 weeks afterwards.
    • Take immune-suppressants for organ transplant.
    • Have Addison's Disease
    • Have current and severe Epilepsy
    • Are recovering from a major surgical procedure
    • Are under 18 years old
    • Have undergone a Bufo ceremony in the past 6 weeks
    • Are pregnant or maybe so or are breast-feeding
    • Taking a daily diuretic. If you are on a medication that is also a diuretic but is not required to be taken daily, check with your practitioner to see if Kambo is safe for you.
    • Person has consumed other strong medicines (eg. San Pedro, Ayahuasca, Mushrooms) within 24 hours of wanting to receive Kambo
    • Person has reached their 70th birthday
    • The person has consumed large amounts of water prior to arriving for Kambo
    • Person has been fasting longer than 18 hours.
    • Person has received the Covid Vaccine in the last 4 weeks
  • Substance Guideline List

    Please review the below list of substances that should be abstained from before and after taking Kambo. By checking the "I Agree" box to each substance you are confirming that you understand the time period to abstain from that particular substance both pre and post Kambo and that you understand the dangers involved should you choose to neglect the information provided to you regarding the substance guideline. 

    SUBSTANCE MINIMUM ABSTINENCE PERIOD PRIOR TO KAMBO / POST KAMBO

  • Sacred Heart Kambo


    “Kambo Session” Release of Liability and Assumption of Risk Agreement

    Disclaimer:
    Kambo is the sweat from the Bicolor Phyllomedusa frog. Traditionally, Kambo is and has been used by Indigenous peoples of the upper Amazon to lift Panema (dark or negative energy) and for Hunting Magic. Your organizer and practitioner are not licensed in the medical field and do not diagnose or prescribe any medications for any conditions, nor do they diagnose, treat, or cure any medical conditions. Kambo treatment should not be used as a substitute for medical care and advice from your physician. Please contact a qualified, licensed physician for any illness or disease.

    In consideration for being allowed to participate in the Kambo treatment I agree to the following:

    1. AGREEMENT TO FOLLOW DIRECTIONS. I agree to follow any oral instructions or directions given by the Sacred Heart Kambo representative practitioners.

    2. ASSUMPTION OF THE RISKS AND RELEASE. IN THE EVENT THAT YOU ARE EXPERIENCING ACUTE ADVERSE EFFECTS RELATED TO YOUR USE OF KAMBO, CALL 911. I recognize that there are certain inherent risks associated with the above-described activity and I assume full responsibility for personal injury to myself and (if applicable) my family members, and further release and discharge Sacred Heart Kambo and Gris Marchon for injury, loss, or damage arising out of my or my family’s use of or participation in any services provided by Sacred Heart Kambo/Gris Marchon, whether caused by the fault of myself, my family, or Sacred Heart Kambo/Gris Marchon. Furthermore, I understand that the known possible side-effects to participating in a Kambo session may include, but are not limited to, the following:


    a. Increased heart rate
    b. Flushing of the skin
    c. Slight pressure in the head
    d. Numbness, tingling in various parts of the body
    e. Flu-like symptoms to include nausea, chills, abdominal cramping
    f. Tetany


    3. FEES. I agree to pay for all damages to any facility in which I partake of Sacred Heart Kambo/Gris Marchon services, caused by any negligent, reckless, or willful actions by me or any minor in my charge.

    4. APPLICABLE LAW. Any legal or equitable claim that may arise from participation in the above shall be resolved under Texas law.

    5. NO DURESS. I agree and acknowledge that I am under no pressure or duress to sign this Agreement and that I have been given a reasonable opportunity to review it before signing. I further agree and acknowledge that I am free to have my own legal counsel review this Agreement if I so desire. I further agree and acknowledge that Sacred Heart Kambo/Gris Marchon has offered to refund any fees I have paid to use its facilities if I choose not to sign this Agreement.

    6. ARM’S LENGTH AGREEMENT. This Agreement and each of its terms are the product of an arm’s length negotiation between the Parties. In the event any ambiguity is found to exist in the interpretation of this Agreement, or any of its provisions, the Parties, and each of them, explicitly reject the application of any legal or equitable rule of interpretation which would lead to a construction either “for” or “against” a particular party based upon their status as the drafter of a specific term, language, or provision giving rise to such ambiguity.

    7. ENFORCEABILITY. The invalidity or unenforceability of any provision of this Agreement, whether standing alone or as applied to a particular occurrence or circumstance, shall not affect the validity or enforceability of any other provision of this Agreement or of any other applications of such provision, as the case may be, and such invalid or unenforceable provision shall be deemed not to be a part of this Agreement.

    8. DISPUTE RESOLUTION. The parties will attempt to resolve any dispute arising out of or relating to this Agreement through friendly negotiations amongst the parties. If the matter is not resolved by negotiation, the parties will resolve the dispute using the below Alternative Dispute Resolution (ADR) procedure. Any controversies or disputes arising out of or relating to this Agreement will be resolved by binding arbitration under the rules of the American Arbitration Association. The arbitrator’s award will be final, and any judgment may be entered upon it by any court having proper jurisdiction.

    9. INDEMNIFICATION. I, for myself and on behalf of my heirs, assignees, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY (reimburse for any loss including any reasonable legal fees that may incur), AND HOLD HARMLESS THE ORGANIZER AND KAMBO PRACTITIONER, their officers, officials, agents and/or employees, other participants, and, if applicable, owners and leasers of premises used for the Kambo treatment ceremony (“RELEASED PARTIES”), with respect to any and all injury, disability, death, or loss or damage to person or property, WHETHER ARISING FROM NEGLIGENCE OF THE RELEASED PARTIES OR OTHERWISE, to the full extent permitted by law. I KNOWINGLY AND FREELY ASSUME ALL RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASED PARTIES or others, and assume full responsibility for my participation.

    I HAVE READ THIS REALEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, I FURTHER UNDERSTAND THAT BY SIGNING THIS RELEASE, I VOLUNTARLIY SURRENDER CERTAIN LEGAL RIGHTS. 

  • Participant's Information

  • Format: (000) 000-0000.
  • Date of Birth*
     - -
  • Health Condition Disclosure

  • To ensure your safety during the Kambo session, it is essential that you provide accurate and complete information about your health. Please disclose any medical conditions, mental health concerns, current medications, or past treatments that could potentially affect your participation in the session. This includes, but is not limited to:

    • Heart Conditions (e.g., arrhythmia, history of heart attack, high blood pressure, etc.)
    • Neurological Conditions (e.g., epilepsy, stroke, or nerve disorders)
    • Respiratory Conditions (e.g., asthma, chronic obstructive pulmonary disease (COPD), etc.)
    • Mental Health Conditions (e.g., anxiety, depression, PTSD, bipolar disorder, etc.)
    • Autoimmune Disorders
    • Current Medications (e.g., antidepressants, blood thinners, beta blockers, or any prescriptions for chronic conditions)
    • Surgical History (e.g., major surgeries within the past six months)
    • Allergies (e.g., to medicines, animals, or environmental factors)
    • Substance Use (e.g., recent consumption of alcohol, recreational drugs, or prescription medication not previously disclosed)
    • Other Health Concerns (e.g., pregnancy, breast-feeding, recent vaccinations, or fasting over 18 hours)

    By signing below, you acknowledge that you have disclosed all relevant health information and affirm that you are physically and mentally able to participate in the Kambo session. Failure to provide truthful and complete information may result in adverse effects for which the practitioner cannot be held responsible.

  • Participant's Signature

  • Emergency Contact Information

  • Format: (000) 000-0000.
  • Should be Empty: