• Kalama Retreats Informed Consent Agreement

    Please review and acknowledge each section to participate.
  • Welcome & Informed Consent

  • Thank you for taking the time to read this informed consent agreement.

    The work we are engaging in together is meaningful and powerful. Experiences involving deep personal reflection and altered states of awareness can offer insight, healing, and transformation. At the same time, this work asks for care, honesty, and personal responsibility from everyone involved.

  • Access to these medicines and practices is not something to be taken lightly. Many cultures have held these traditions with deep reverence for generations, and today they exist within complex legal and ethical boundaries. Participating in this retreat is a privilege, and it asks each participant to approach the experience with respect, integrity, and awareness.

  • My role as facilitator is to prepare a thoughtful and supportive container, offer guidance, and help maintain a safe and respectful environment. At the same time, each participant remains fully sovereign and responsible for their own decisions, actions, and wellbeing.

    This agreement helps ensure that everyone entering the retreat understands the nature of the experience and the shared responsibility we hold for the safety and integrity of the space.

  • Nature of the Retreat Experience

  • The retreat you are attending is designed as a personal growth and wellness experience. Activities may include guided reflection, group sharing, movement practices, meditation, time in nature, and other experiences intended to support insight, connection, and personal exploration.

    Each participant’s experience is unique. While many people find these experiences meaningful or transformative, specific outcomes cannot be guaranteed.

  • Personal Responsibility & Sovereignty

  • By participating in this retreat, you acknowledge that you are choosing to engage in this experience voluntarily and of your own free will.

    You understand that you remain fully responsible for your own physical, emotional, and psychological wellbeing throughout the retreat.

    You acknowledge that any decisions you make during the retreat — including what you choose to consume, ingest, or participate in — are entirely your own responsibility.

    The facilitator and retreat organizers do not make these decisions on your behalf. You are responsible for assessing your own comfort, readiness, and personal risk tolerance.

  • Honest Health Disclosure & Reciprocity of Care

  • The safety of this work depends on a relationship of mutual honesty and responsibility.

    As a facilitator, I commit to preparing the retreat space with care, providing thoughtful guidance, and doing everything within my capacity to support a respectful and supportive environment.

    In return, participants are expected to provide honest and complete information about their physical health, mental health history, medications, and any relevant personal circumstances in the intake process.

    Certain medications, medical conditions, or psychological histories may create risks when combined with altered states or emotionally intensive experiences. Full disclosure is essential for your safety, the wellbeing of the group, and the integrity of the retreat.

    By signing this agreement, you affirm that the information you have provided in your intake form is accurate and complete to the best of your knowledge.

    You also agree to inform the facilitator if any relevant health information changes prior to the retreat.

  • Potential Risks & Emotional Intensity

  • Experiences involving deep personal reflection or altered states of awareness may bring up strong emotions, memories, or psychological material.

    Participants may experience periods of emotional intensity, vulnerability, or discomfort as part of the process.

    While facilitators will do their best to create a supportive environment, you understand that personal growth work can involve emotional challenges and unpredictable experiences.

  • Facilitator Role

  • The facilitator’s role is to prepare and maintain a supportive environment and to offer guidance, education, and emotional support.

    The facilitator is not acting as a medical doctor, psychologist, or licensed mental health provider unless explicitly stated otherwise.

    Participation in this retreat should not be considered medical treatment, psychological therapy, or a substitute for professional healthcare.

  • Confidentiality & Group Respect

  • Participants may share personal experiences during group discussions. You agree to respect the privacy and confidentiality of other participants.

    Stories, identities, and personal information shared within the group should remain within the group.

    This commitment helps maintain trust and safety for everyone participating.

  • Integration & Aftercare

  • Insights and emotions may continue to unfold after the retreat experience.

    Participants are encouraged to seek supportive practices such as therapy, coaching, journaling, or integration support to help process and integrate their experience.

  • Liability Release

  • By participating in this retreat, you acknowledge that you are voluntarily engaging in this experience and accept responsibility for your own decisions and actions.

    You agree to release and hold harmless the retreat facilitator, organizers, and associated individuals from liability for any injury, loss, or damages that may arise from your participation, except in cases of gross negligence or misconduct.

  • Agreement & Signature

  • Date*
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