Liability Waiver

                                                                  APOYA PALM CENTER - RELEASE OF LIABILITY                                                                                                                                                                                     

I understand that Ceremony work may include the use of traditional healing plants and Shaman healing work. I agree that I always have a choice whether or not to participate, and I agree to take full responsibility for the choices I make involving this work, both during and after the event. To the best of my knowledge, I am in good emotional, psychological, mental, as well as physical condition and I am not aware of any physical, physiological, or psychological infirmity which would place me at risk to participate in any way within the ceremonial activities. I take full responsibility for my own belongings and safe transportation to and from the ceremony/workshop/retreat. I acknowledge that I have fully complied with all instructed preparation for the retreat and ceremonies. I have been given the opportunity and have been encouraged to seek independent legal advice prior to signing this Waiver and Release agreement.

I hereby acknowledge that I have voluntarily applied to participate in the “Ceremony of Yage” and related activities and programs run and/or operated by Apoya Palm Center, it’s organizers, employees, host/hostesses, facilitators, founders, members, associates, agents, staff, family, successors, volunteers, helpers, shamans/healers who are participating in the ceremony, any and all property owners where the retreat and  Ceremonies occur, owners, officers, directors, representatives, associates, members, agents, facilitators, assignees, legal representatives of the above noted activity and each of them their owners, officers and employees,(referred to hereafter as Releasees) and partake of Traditional Amazonian Plant Medicines administered by the Releasees, and/or any organized activities and programming on site or in the region and associated properties of said Releasees, do waive, release, discharge, and agree to hold harmless, from all liability for or by reason of any damage, loss, injury to person and property, even injury resulting in the accidental death of the Releasor, which has been or may be sustained in consequence of the Releasor’s participation in the activities described above or sustained on the grounds and property of the Releasees or during organized programming in regions conducted by the Releasees, and notwithstanding that such damage, loss or injury may have been caused solely or partly by the negligence of the Releasee.

I hereby acknowledge and agree that by signing this release I have read the information sheet and acknowledge the risks and responsibilities of my participation in the above stated activities to others and myself. I understand that this Waiver and Release agreement is binding on me, my spouse, my heirs, my executors, administrators, personal representatives and assignees. I acknowledge that I do not have any limitations, ailments or disabilities that would limit or prevent me from participating in the above mentioned activity, and, if required, will obtain a medical examination and clearance.  If I have any such disabilities that I am aware of that I will inform the Releasee in writing before participating in such activities. This release contains the entire agreement between the parties to this release and the terms of this release are contractual and not a mere recital. I understand that the Releasees reserve the right to deny my participation if they deem that it would be unsafe for me, or for others, or for any other important reason. I agree to listen and follow the instructions given by the Releasees. I take full responsibility for any damage that I may cause to the facility that is used for the ceremonies and retreat. I agree to maintain the safety, trust and respect for all participants, I agree to hold this work confidential. I will not reveal to anyone the identity of those who are participating in the event. I hereby release, waive, discharge, agree to hold harmless and commit to not sue the Releasees.

I agree to participate with the purest intention of heart, promoting the health and well-being of all participants.In signing this release I acknowledge and represent that I have read and understand the above and sign voluntarily; I execute this release for full, adequate and complete release of liability. I assume full risk of any physical or other injury, damage or losses either to myself or others by me during the Retreat and Ceremonies. I hereby acknowledge the relationship between I, the Participant and the Organizers and in the unlikely event that a controversy arises which cannot be resolved between Releasee and I, the Releasor,  both parties agree to the exclusive jurisdiction on of the Ecuadorian courts of Quito.

 

                                                           Signature________________________ Date_________________

 

                                                            Witness________________________  Date_________________           

2852 Willamette st #165

Eugene, OR 97405

apoyapalmcenter@gmail.com

2019 created by James for Apoya Palm Center