Peyote Ceremony

Agreement & Waiver

In exchange for the services provided to me by Right to Heal; Right to Heal Mexico; Right to Heal Retreats; Direcho a Sanar; their agents, employees, officers, volunteers, and contractors; and any person or organization associated with them and their activities (collectively “RTH,” or “Company”), I, for myself and anyone who may act on my behalf, (hereinafter referred to collectively as “I and/or my Heirs” agree to and acknowledge the following:

1. Risks.

I am voluntarily participating in a program of personal growth and learning. RTH will involve a variety of activities (the “Activities), including, but not limited to: mindfulness practice, yoga, consumption of entheogenic (psychoactive) substances of plant and/or synthetic origin, group counseling, exercise, sweat lodge, leadership exercises, didactic learning, sound healing, breath work, non-sexual touch and bodywork, energy healing, lecture, visualization exercises, dialoguing, gentle movement, meditation, and/or other activities.

These activities may be strenuous, vigorous, and challenging physically, mentally, emotionally, and intellectually, and may be conducted indoors, outdoors, or both. The same elements which contribute to the unique character of RTH and the associated Activities can cause loss or damage to personal property, accidental injury, illness, or, in extreme cases, permanent trauma, disability, or death.

The risks discussed above include, but are not limited to:

  • Risks associated with outdoor physical activities (such as walking or running on uneven ground) including slips and falls, bruises, sprains, lacerations, fractures, and concussions;
  • Contact with plants, animals, snakes or insects that could cause stings, bites, allergies, or disease;
  • Exposure to fire or heat from natural or manmade causes that could cause burns, dehydration, and fainting;
  • Exposure to cold, wet weather, and to other unpredictable forces of nature;
  • Exposure to the conduct of other RTH participants;
  • Damage to property owned by me or by others;
  • The failure or malfunction of equipment;
  • Inherent risks associated with being in a remote location, distant from medical facilities, where evacuation and medical care could be delayed; and
  • Risks associated with traveling by land or air to and from the RTH site or to and from a site of emergency to medical care.

I understand that there is no way to predict the results of this work. I also understand that risks associated with the Activities may include my mental, emotional, and/or spiritual response, including:

  • Not feeling much of anything, or experiencing a “failure to launch,”
  • Surfacing of difficult and/or suppressed memories or feelings
  • Feeling worse after this work
  • Confusion, inconvenience, emotional pain, or other suffering as a result of the process
  • Experiencing hypomania, mania, or psychosis
  • Having a seizure
  • Experiencing negative drug-drug interactions, which could result in medical emergency, hospitalization, and in rare circumstances death

I agree to discuss my experiences with the facilitators and group, as they may be an important part of my healing and/or the learning, growth, or healing of another member of the group. I understand that sometimes in doing this work things may get worse before things get better.

I understand that I will be offered additional or “booster” doses of psychoactive medicines after my initial dose. I hereby give my consent to the staff to offer me such boosters, and understand I have the right to decline them in the moment.

I understand that this list is not complete and that other unknown or unanticipated risks may result in property loss, serious injury, illness, or death. I understand that psychedelic-assisted healing is considered an experimental therapy, that no outcomes are guaranteed, and that other risks not yet identified with this work may exist.

2. Medical Care.

I attest that (1) I have no medical, physical, mental, or emotional conditions which could interfere with or affect my safety while participating in the RTH and the Activities, and I am fully capable both physically and mentally of participating in the RTH and associated Activities without causing harm to myself or others; or

(2) if I have, or suspect I may have, any such condition I have disclosed it fully to RTH, and I am proceeding knowing that I am taking a risk and I am ultimately responsible for that risk of harm. I release and forever discharge RTH from any liability or claims for any injuries to me which are a direct or indirect result of my medical or psychological condition.

I understand that people may touch me to enter “my bubble” to deliver medical or safety interventions, or comfort.

I agree to take all of my prescription medications as prescribed, unless instructed to do so otherwise by my prescriber. I understand that my healthcare provider is the only person who should be guiding my decision to stop a medication, reduce the dosage, continue a medication, or partake in this Event at all.

3. Assumption of Risk.

I understand and agree that RTH is not and cannot be a guarantor or insurer of my safety or well-being. I agree to act with reasonable care for my well-being and the well-being of all other people and property around me during the RTH and the Activities. I also understand that swimming pools or other bodies of water that could be used for swimming may be present at the locations where the RTH is held. I understand that RTH has not inspected and makes no warranty regarding the condition of those pools or other bodies of water and provides no lifeguards. I agree that if I swim or otherwise enter those bodies of water, I do so at my own risk.

I accept and assume full responsibility for all of the risks and hazards associated with participation in the RTH, whether known or unknown, including, but not limited to:

1) injury, death, or loss of personal property and related expenses which I may suffer as a direct or indirect result of those inherent risks and dangers described in this Agreement as well as those not specifically described; and

2) any injury that I may cause to any other person or any damage that I may cause to the property of others, as a result of my negligence or wrongful conduct. I elect to participate in the RTH with full knowledge of all known or potential risks.

4. Voluntary Participation.

I confirm that my participation in any and all Activities is purely voluntary, and that I may decline to participate in any of the Activities at any time. The one exception to this is if revoking my participation could pose a risk to my safety. For example, after I have ingested a psychoactive substance, I understand that I will not be allowed to leave until I am fully lucid.

5. Release.

In consideration of being able to participate in the RTH Activities, I, for myself and my Heirs, release and discharge RTH from all claims or causes of action, present or future, arising from physical, emotional, or psychological injury, death and/or property damage suffered by me or any other person, resulting directly or indirectly from my participation in the RTH and the associated Activities, including, without limitation, injury or damage caused in whole or in part by errors in judgment and/or any other negligence of RTH.

I understand and accept that by signing this Agreement, I surrender all rights to make a claim or file a lawsuit against RTH for personal injury, property damage, wrongful death, products liability (including strict liability), breach of warranty or contract, or under any other legal theory, unless the claim arises from the intentional wrongful act, recklessness, or gross negligence of RTH.

6. Nature of Release & Indemnification.

This release, waiver, and indemnity Agreement is intended to be as broad and inclusive as permitted by the laws of wherever the Event occurs, and not necessarily where I live. If any portion of the Agreement is held invalid, the remainder of the Agreement will still continue in full legal force and effect.

7. Promise of Confidentiality.

While participating in the event, I will learn details of the personal lives of the other participants. I agree to hold this privileged information in confidence. I also agree to hold in confidence the details of RTH agents’ personal lives.

8. Photo Release.

I, the undersigned, do hereby consent and agree that RTH’s employees or agents have the right to take photographs/videos/voice recordings of myself for use in any and all media, including, but not limited to, social media pages, YouTube, website, fliers, and other marketing materials. I understand that my name and identity will not be disclosed unless I explicitly agree to this in writing. 

I do hereby release to RTH, its agents, and employees all rights to exhibit this work globally in print and electronic form publicly or privately. I waive any rights, claims, or interest I may have to control the use of my said photos/videos/recordings in whatever media used, in perpetuity. 

I waive the right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of my image. 

9. Medical Authorization.

I hereby authorize RTH to obtain any reasonably necessary emergency, surgical, or other medical care for me, including hospitalization, if I am unable to do so myself.

I understand that RTH is under no obligation relating to my medical care and is not responsible for ensuring the presence of any medical professionals at the Activities. In the event that any representative, volunteer, affiliate or agent of RTH voluntarily administers emergency medical care to me, I hereby release such individual(s) from any and all liability with respect to such emergency medical care.

10. Scope of Work

I understand that this Event is not being conducted under any professional license as a practitioner, and as such, the same rights, privileges, and restrictions are not extended to this work.

Even if one or more of the staff are licensed practitioners, I understand that they are not working within the context of those licenses during the Event. Should any complaints arise from my participation in the Activities, I therefore agree that I will not report RTH leadership to any professional licensing boards.

This event is not meant to replace or supersede medical attention, psychiatry, or any such professional help.

Because this work does not fall under the scope of healthcare, it is not covered by any health insurance or malpractice policy. Likewise, the site of the Event may or may not carry any liability or umbrella insurance. I will take full responsibility for myself, my choices, and the risks I take by engaging in this work. 

11. Weapons and drugs.

I agree that I will not bring any weapons onto the premises for the entire duration of the Event. I likewise agree not to bring any illicit substances or event-banned substances (such as alcohol and cannabis) onto the premises for the duration of the entire Event.

I understand that if I am suspected to be at risk of violating this agreement, or if the staff are seriously concerned that I may harm myself or others, that my room, person, and luggage may be searched. I hereby consent to such a search.

SIGNATURE

I have read the Agreement in its entirety, I understand the content and implications of the document, I sign this Agreement freely and voluntarily, and I agree to be legally bound by all of the terms and conditions of this Agreement.

I am of sound mind and body, participate voluntarily, and understand that I am personally responsible for my experience.

I understand that if I have any questions or would like additional information, I am free to ask at any time before or during the Event and its Activities.