I have read and agree to Accident Waiver and Release of Liability Agreement and Waiver of Liability and Warrenties
HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN ANY/ ALL ACTIVITIES ASSOCIATED WITH THIS EVENT, including by way of example and not limitation, any risks that may arise that are not caused by direct negligence of the parties to be waived.
I certify that I am physically fit, have sufficiently prepared or trained for participation in this activity, and have not been advised to not participate by a qualified medical professional.
I certify that there are no health-related reasons or problems which preclude my participation in this activity.
I acknowledge that this Accident Waiver and Release of Liability Form will be used by the event holders, sponsors, and organizers of the activity in which I may participate, and that it will govern my actions and responsibilities at said activity. In consideration of my application and permitting me to participate in this activity,
I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: (A) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this activity,
THE FOLLOWING ENTITIES OR PERSONS: Subconscious Retreats, and/or their directors, officers, employees, volunteers, representatives, and agents, and the activity holders, sponsors, and volunteers; (B) INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this activity.
I acknowledge that Subconscious Retreats and its directors, officers, volunteers, representatives, and agents are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity conducting a specific activity on their behalf.
I acknowledge that this activity may involve a test of a person’s physical and mental limits and carries with it the potential for death, serious injury, and property loss.
The risks include but are not limited to, those caused by terrain, facilities, temperature, weather, condition of participants, equipment, vehicular traffic, lack of hydration, and actions of other people including, but not limited to, participants, volunteers, monitors, and/or producers of the activity.
These risks are not only inherent to participants but are also present for employees.
I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during this activity.
The Accident Waiver and Release of Liability Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.
I CERTIFY THAT I HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I AGREE TO IT OF MY OWN FREE WILL RELEASE OF LIABILITY, WAIVER OF CLAIMS AND ASSUMPTION OF RISKS (Subconscious Retreats) BY SIGNING THIS DOCUMENT, YOU WILL WAIVE CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE OR CLAIM COMPENSATION PLEASE READ CAREFULLY!
The individual named below (referred to as “I” or “me”) desires to participate in a wellness retreat, which includes but is not limited to related activities and excursions such as lodging, access to lodging premises and facilities, outdoor recreational activities and excursions, traveling by automobile, and mindfulness and meditation activities (the “Activity”) provided by (Subconscious Retreats), and its, affiliates, subsidiaries, agents and assigns (the “Company”) at or near Gran Canaria, and surrounding areas. Furthermore,
I desire to participate in Kambo, Bufo 5 MeO-DMT, and Ayahuasca, sessions, as particularized in the marketing material, and acknowledge that no medical treatment or psychotherapy is offered or will be available at the retreat;
and that the psychedelic Kambo, Bufo 5 MeO-DMT, and Ayahuasca available with this retreat do not and will not cure or mitigate any physical or mental disease, symptoms, disorders, or abnormalities.
As lawful consideration for being permitted by the Company to engage in the Activity and/or the intangible value that I will gain by participating in the Activity,
I agree to all the terms and conditions set forth in this agreement (this “Agreement”). Assumption of Risks.
I am aware and understand that the Activity is a potentially dangerous activity and involves the risk of serious injury, disability, death, or property damage and other potential risks described herein (the “Risks”).
I acknowledge that I will be consuming food and drink from various establishments and restaurants while taking part in the Activity, and I understand that the Company makes no guarantees, representations or warranties, whether express or implied, regarding any food or drink I may consume.
Any ill effect from any food or drink or Kambo, Bufo 5 MeO-DMT, and Ayahuasca extract, including but not limited to food poisoning, intoxication, sickness, or allergic reaction shall not be the fault or responsibility of the Company.
I expressly and voluntarily assume any risk related to the consumption of Kambo, Bufo 5 MeO-DMT, and Ayahuasca extracts, food or drink during the Activity.
I am also aware of the highly contagious nature of bacterial and viral diseases including the novel coronavirus disease (COVID-19) (the “Disease”) and the risk that I may be exposed to or contract the Disease or other infectious diseases by engaging in the Activity, which may result in serious illness, personal injury, disability, death, or property damage.
I am aware and understand that the consumption of psychedelics ie, Kambo, Bufo 5 MeO-DMT, and Ayahuasca is a potentially dangerous activity and involves the risk of serious injury, disability, death, or property damage and other potential risks and side effects described herein (the “Medicine Risks”).
I understand and acknowledge that these risks may result from or be compounded by the actions, omissions, or negligence of Company employees or others, including negligent emergency response or rescue operations of the Company.
I understand that while the Company has implemented measures to reduce the risk of injury from the Activity, consuming psychedelics and related activities, and the spread of the Disease, the Company cannot guarantee that I will not be injured or become infected with the Disease due to my participation in the Activity.
Risks include but are not limited to the following: given the remoteness and access to emergency care access to treatment from the result of any mishap could be significantly delayed exacerbating any medical or health problem; guide or leader decision making while hiking, snorkeling, swimming, walking, or participating in other retreat Activities,
including that a staff member may misjudge terrain, weather, trail or water conditions, and water level; risks of drowning, and such other risks, hazards and dangers that are integral to recreational activities that take place on the island in an outdoor or recreational environment; slip and fall risks at the Resort or while on excursions, such as failure of the resort to adequately maintain or inspect the property, misjudging uneven ground, slippery conditions, steepness of slope or even misjudging my own competence and abilities; risks of equipment failure; wet conditions.
Kambo, Bufo 5 MeO-DMT, and Ayahuasca Risks and potential side effects include upset stomach and vomiting; intensified feelings and sensory experiences; changes in sense of time (for example, time passing by slowly); increased blood pressure, breathing rate, or body temperature; loss of appetite; dry mouth; sleep problems; mixed senses (such as “seeing” sounds or “hearing” colors); spiritual experiences; feelings of relaxation or detachment from self/environment; uncoordinated movements; lowered inhibition; excessive sweating; panic; paranoia – extreme and unreasonable distrust of others; psychosis – disordered thinking detached from reality.
Larger Bufo 5 MeO-DMT and Ayahuasca doses can lead to intense hallucinogenic effects over a longer period of time.
An intense “trip” episode may occur, which may involve panic, paranoia, psychosis, frightful visualizations (“bad trip”), and very rarely death.
The memory of a “bad trip” can last a lifetime. By my participation in these Activities and/or use of equipment,
I hereby assume ALL risks and dangers and all responsibility for any losses and/or damages whether caused in whole or in part by the negligence or other conduct of the owners, agents, officers, or employees of the Company, or by another person.
Furthermore, if I do not feel safe or have any misgivings about a given Activity or excursion,
I acknowledge I have a choice whether or not to voluntarily participate, and I agree not to participate and also agree to immediately express any misgivings or concerns to a staff member or retreat leader.
I ACKNOWLEDGE THAT I AM VOLUNTARILY PARTICIPATING IN THE ACTIVITY WITH KNOWLEDGE OF THE DANGERS INVOLVED. I HEREBY AGREE TO ACCEPT AND ASSUME ALL RISKS OF INJURY, ILLNESS, DISABILITY, DEATH, OR PROPERTY DAMAGE ARISING FROM MY ENGAGING IN THE ACTIVITY, WHETHER CAUSED BY THE NEGLIGENCE OF THE COMPANY OR OTHERWISE.
Waiver of Liability and Warranties. I hereby expressly waive and release any and all claims which I have or may in the future have, against Subconscious Retreats, and its officers, directors, employees, agents, representatives, affiliates, shareholders, successors, and assigns (collectively, “Releasees”), on account of injury, illness, disability, death, or property damage arising out of or attributable to my participation in the Activity, whether arising out of the negligence of the Company, the Resort, retreat staff, their agents or employees or any other Releasee or otherwise, including without limitation, breach of contract, tort including but not limited to negligence or breach of any statutory or other duty of care or purported duty of care.
I covenant not to make or bring any such claim against the Company or any other Releasee and forever release and discharge the Company and all other Releasees from liability under such claims.
I further waive all warranties implied or express under the Spanish Sale of Goods Act pertaining to the psychedelics or other goods purchased by me at the retreat.
Acknowledgment of Good Health. I confirm that I am: (a) in good health, in proper physical condition, and do not have any medical or other conditions that would impair my ability to participate in the Activity and have disclosed truthfully all of my current conditions to the physician for his independent purposes involving any medical treatment conducted onsite; and (b) not experiencing symptoms of the Disease (such as cough, shortness of breath, or fever), do not have a confirmed or suspected case of the Disease, and have not come in contact in the last fourteen days with a person who has been confirmed or suspected of having the Disease.
I also agree that I have a duty to disclose these symptoms and/or contact with any infected individuals that occur following the execution of this document but prior to the retreat.
I will comply with all federal, state, and local laws, orders, directives, and guidelines related to the Activity and the Disease while participating in the Activity, including, without limitation, requirements related to hand sanitation, social and physical distancing, and use of face coverings and safety equipment.
I will also follow all instructions, recommendations, and cautions of the Company at all times during the Activity.
If at any time I believe conditions to be unsafe, that I am no longer in proper physical condition to participate in the Activity, or I begin experiencing symptoms of the Disease,
I will immediately discontinue further participation in the Activity.
I understand that it is my duty to report any discomfort or misgivings regarding any Activity to retreat staff. Hold Harmless.
I shall defend, indemnify, and hold harmless the Company and all other Releasees against any and all losses, damages, liabilities, deficiencies, claims, actions, judgments, settlements, interest, awards, penalties, fines, costs, or expenses of whatever kind, including reasonable legal fees, fees, and the costs of enforcing any right to indemnification under this Agreement, and the cost of pursuing any insurance providers, incurred by/awarded against the Company or any other Releasees, arising out or resulting from any claim of a third party related to my participation in the Activity. Scope of Agreement.
This Agreement constitutes the sole and entire agreement of the Company and me with respect to the subject matter contained herein and supersedes all prior and contemporaneous understandings, agreements, representations, and warranties, both written and oral, with respect to such subject matter.
If any term or provision of this Agreement is invalid, illegal, or unenforceable in any jurisdiction, such invalidity, illegality, or unenforceability shall not affect any other term or provision of this Agreement or invalidate or render unenforceable such term or provision in any other jurisdiction.
This Agreement is binding on and shall inure to the benefit of the Company and me and our respective successors and assigns.
I ACKNOWLEDGE THAT I HAVE READ AND UNDERSTOOD ALL OF THE TERMS OF THIS AGREEMENT, THAT I WAS GIVEN THE OPPORTUNITY TO SEEK INDEPENDENT LEGAL ADVICE ON THE TERMS AND THAT I AM VOLUNTARILY GIVING UP SUBSTANTIAL LEGAL RIGHTS (ON MY BEHALF AND ON BEHALF OF MY HEIRS, EXECUTORS, ADMINISTRATORS AND NEXT-OF-KIN), INCLUDING THE RIGHT TO SUE THE COMPANY AND THE RELEASEES.