Retreat Agreement & Waiver
Participant Agreement and 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:
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 (such as yoga, t’ai chi, and dance), meditation, and/or other activities.
I understand that RTH does not want to reduce my enthusiasm for participating in the Activities, and that RTH as a matter of integrity and accountability wants me to know in advance of the inherent or potential risks of the associated Activities. I understand that RTH will take reasonable steps to seek to provide a safe environment. However, I also understand that certain risks are inherent in and cannot be eliminated without destroying the unique character of the 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 this may be a natural part of the process. I understand that I am welcome to discuss these issues when/if they arise.
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 further certify that I have no past or present physical or psychological condition that might affect my participation in the RTH or the Activities, other than those which I have disclosed on my medical form.
I understand that people may touch me to enter “my bubble” to deliver medical or safety interventions.
I understand that certain medical and psychological conditions may increase the risk of my participation in the RTH. 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.
The medical information which I have given to RTH is true, to the best of my knowledge, information, and belief and I have disclosed all known or suspected medical conditions. I agree that I will inform RTH of additional medical conditions that may arise between the day I execute this Agreement and the date of the RTH and Activities as well as conditions that arise during the course of the and Activities.
I agree to arrive to the Event completely sober from alcohol, cannabis, and other substances, and agree that I will not use such substances during the entirety of the Event unless guided to do so. I also agree that RTH has the right to search my luggage, room, and person should it be suspected that I have brought harmful or forbidden substances.
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, I understand that my consent to participate in the ingestion or consumption of a psychoactive substance cannot be revoked after the substance has been taken.
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
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.
I agree to indemnify and defend RTH against and hold RTH harmless from any claims arising out of my acts or omissions in the Activities. The terms “indemnify” and “defend” mean that I will defend and protect RTH by payment or reimbursement for any costs or expenses incurred by RTH. This indemnification includes reimbursing RTH for reasonable attorneys’ fees and related costs of litigation, including discovery.
8. Participant Promise of Confidentiality
While participating in the retreat, I will learn details of customs, protocols, traditions, exercises, rituals, processes and other information, in both oral and written form, which are proprietary and owned exclusively by RTH (the “Proprietary Information”). In addition, I may learn during the course of the RTH information about other participants which is confidential (the “Confidential Information”).
I will take all reasonable measures to protect the secrecy of and avoid disclosure or use of Confidential Information of RTH, its agents, and its clients in order to prevent it from falling into the public domain or the possession of persons outside of RTH.
As an express condition of my participating in the RTH, I agree that I will not reproduce, duplicate or copy, in any form or manner, any Proprietary Information without the written permission of RTH.
I further agree that I will not disclose in any form or manner, written or oral, any Confidential Information which I learn as a result of my participation in the RTH Activities. I may, however, share my personal experience of the RTH as long as I do not disclose any Confidential Information.
“Confidential Information” means any information, technical or scientific data, plans or know-how (whether disclosed before or after the date of this Agreement), including, but not limited to business and service development activities, medical information, financial projections, business forecasts, sales and marketing plans, organizational charts, employee compensation, patents, patent applications, market/patient/physician research, inventions, processes, designs, and financial information. This confidential information is deemed proprietary to RTH and must not be shared with anyone outside of RTH.
This work does not have an internet presence (it is not on Yelp, Facebook, etc.), I agree to share my feedback (positive, negative, or ambivalent) privately with the staff or in group, as it is likely very important for my work. I agree not post reviews of this work anywhere online or in public forums unless invited directly by RTH staff to do so.
I also agree to hold in confidence details of RTH agents’ personal lives.
9. RTH's Promise of Confidentiality
The Activities do not fall under the scope of HIPAA in the United States. Nevertheless, RTH agrees to maintain the confidentiality of Confidential Information as stated above. However, if a participant, staff, or leader in any RTH Event reveals recent or continuing acts that place themselves or another person in danger of significant physical, emotional, or psychological harm, or is considering engaging in such acts in the foreseeable future, RTH may be mandated by law to report such information to an appropriate agency or organization. The same applies for damage to property.
Should the staff learn something about me that indicates that this work may be unsafe for me, them, or others, they may share the minimal amount of information with other practitioners to help ensure everybody’s safety.
In the event of a grievance, I understand that RTH staff may need to disclose confidential information for the purposes of confidential peer support and legal guidance.
Even in the absence of a legal mandate, RTH may act to protect the participant or any other person from foreseeable harm, while providing the participant a path of healing and support. By signing this agreement, I consent to RTH acting in this manner.
I understand that in the spirit of continual learning and improvement, the RTH staff may share de-identified pieces of my experience with a consultation groups, when teaching publicly, or in other settings.
10. 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.
I represent that I am at least 18 years of age, have read and understand the foregoing statement, and am competent to execute this agreement.
11. Health and Liability Insurance
I confirm that I have adequate health and/or other insurance to cover any injury or damage I may cause or suffer while participating in the Activities, or that I agree to bear the costs of such injury or damage to myself, property, or others.
12. 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.
13. 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 or retreat leaders are licensed practitioners, I understand that they are not working within the context of those licenses during the retreat. 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 retreat 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.
14. Mediation, Arbitration, Waiver of Right to Sue
I expressly agree that any claim or cause of action of any kind against RTH as a direct or indirect result of my participation in the Activities or RTH, must first be submitted to mediation by a neutral third party, preferably a mediator who practices regularly under the auspices of the courts of the state where the Event is located.
If after four (4) sessions, mediation is unsuccessful, the matter must then be submitted for a final and binding arbitration of my claims. Any such arbitration will be held in the state where the RTH Event is located. I agree that any resulting arbitration award is final and binding upon both RTH and upon me and my Heirs, and by executing this Agreement I am expressly waiving any and all rights to litigate any such claim in any state or federal court.
15. Agreement Controlling
This release contains the entire agreement between RTH and me, and supersedes any and all other agreements or representations, written or oral.
I understand fully that by signing this Agreement, I waive my legal rights both to assert certain claims against RTH and to sue or otherwise assert any claims in a court of law. I agree that any dispute between RTH and me, or anyone representing me, or otherwise arising out of my participation in the Activities and the RTH, must be submitted to final and binding arbitration. I fully understand the consequences of this waiver and acknowledge that I have had ample opportunity to ask questions regarding this Agreement.
16. Container Agreements
I understand that each cohort of participants is unique. At the beginning of the Event, participants will be asked to finalize and consent to their container agreements to help everyone feel safe physically, mentally, and emotionally. I also understand that there will be Ceremony Agreements before group medicine work. I agree to uphold these agreements in good faith, and understand that I may ask questions about them at any time.
I understand that the exact agreements may change from event to event, but will include the following:
- Confidentiality. I will hold in confidence the identities of the other participants and the personal nature of their healing work. I will ask for permission before posting photos of other to social media.
- Touch. All touch offered and given this week will be non-sexual in nature. (Exception: already established partners attending the Event together may engage in consensual touch.) I will respect the boundaries of others and ask first before delivering hugs, shoulder rubs, etc.
- Premises. I agree to stay on the premises for the entire duration of the Event, unless explicitly given permission by an Event Leader. I also agree to stay within the defined ceremony space during medicine-assisted Activities.
- Platonic Healing. I agree not to run romantic energy with anybody else at the Event, for the duration of the entire Event. (Exception: already established partners attending the Event together.)
- Self Care. I will ask for what I need and speak up when I feel unsafe. I will not participate in Activities that I deem to be harmful for my wellbeing.
- Safety. I understand that the safety word is “Safety.” When I hear this word, I will immediately stop whatever I am doing, focus, and follow instructions. This is for my own safety, as well as for the safety of others. Likewise, if I deem that something dangerous is occurring during the Activities, I understand that I can likewise call “safety.”
- Personal Growth. I remember that I am here for the purposes of healing and personal growth, and that such processes often entail confronting parts of myself and others that may be uncomfortable. I agree that the Event staff may remind me of this throughout the week, and understand that they may call me out when I am deflecting, projecting, or acting out of alignment.
- Group Healing. I understand that the healing that happens in groups is different than one-on-one or solo work. I agree to respect the process of other individuals, as it may be quite different than my own. I agree not to touch or speak to other participants during the Group Medicine Ceremony.
- Judgement. I will be mindful of my own judgements and projects as they arise, and when they do, I will choose kindness.
- Attitude of Learning. I understand that there is no such thing as perfection, and that the Event staff and other participants may say or do things I dislike. I understand that this is all part of the learning – both mine and theirs.
17. Agreement Violation
I understand that failure to abide by these Agreements (outlined herein) as well as the Container Agreements may result in my being ejected from the Event. Should this occur, I understand that I will not be entitled to any refunds, and that transportation from the Event and any expenses incurred as a result of my ejection will be my responsibility.
I understand that I will not be removed from the premises of the Event if I am under the effects of a psychoactive substance, but that failure to comply with safety instructions may result in may nevertheless result in being restrained and/or sedated.
My violation of this Agreement may also result in legal ramifications and arbitration.
During the Term of this Agreement, and for a period of two years after the end of the RTH retreat/event, I will not solicit any of RTH’s employees, vendors, or independent contractors for employment, independent contractor work, business partnership, or other professional collaboration without first obtaining written permission from RTH’s CEO. This includes renting space from the retreat site(s) that RTH uses or hiring RTH’s drivers for events. I understand that RTH has the full right to deny and all such requests.
19. Non Compete
During the Term of this Agreement, and for a period of two years after the end of the RTH retreat/event, I will not organize a retreat or other event for more than four adults within the town limits of Tepoztlan, Cuernavaca, and Atlacholoaya, or Valle de Bravo, Mexico; or within a ten-mile (16 kilometer) radius of any of these towns without first obtaining written permission from RTH’s CEO. I understand that RTH has the full right to deny and all such requests. Exception: I may without permission organize retreats in the town in which they live, defined as the address on my government-issued identification, plus a 10-mile (16 kilometer) radius around that address.