As a qualified patient protected by California Law, Health & Safety code 11362.5 and 11362.7, et seq., and, in conjunction with California State Senate Bill 420, you are required to read and agree to the following statements to become a member of Natural Rehabilitation Collective. Please understand that these are for your protection, as well as ours. Please read the following statements and initial that you have read each provided. This confirms that you have read each of the statements and understand them.
I am legally able to use, possess, and cultivate cannabis for medical purposes. I understand that I am allowed to do so through safe and affordable access such as the type provided by Herbolution Organics Collective, therefore, designate Herbolution Organics Collective, as my care provider for this purpose. In doing so, I agree to agree and follow all Herbolution Organics Collective’s, rules and regulations regarding their services. I further authorize Herbolution Organics Collective to create and/or assign agency rights in its own name for the purpose of growing medication and/or obtaining edible forms of medication for my benefit. I also agree to pay all personal out-of-pocket expenses and reasonable compensation for Herbolution Organics Collective's member services.
I hereby declare under penalty of perjury under laws of the State of California that a medical doctor recommended or approved my use of medical marijuana. I have been diagnosed for a serious illness for which cannabis provides relief. I hereby verify that I am a California resident and my personal medical marijuana will not be taken out of the State of California. I further verify and agree that my medical marijuana shall not be shared, sold, bartered, traded, exchanged or delivered in any other means to any other person.
I hereby declare and understand that my contributions Herbolution Organics Collective, and for and through prescribed medicinal products I may acquire from Herbolution Organics Collective, are used to ensure the continued operation of Herbolution Organics Collective, and that any said transaction in no way constitutes a commercial promotion or sale of any item.
As a member, I hereby agree, appoint and designate Herbolution Organics Collective, and their representatives, as my true and lawful agents for the limited purpose of assisting me in obtaining my legally prescribed medicinal marijuana. I understand that this means Herbolution Organics Collective, will be required to purchase, possess, transport and distribute my medication to me as prescribed by my physician and I grant them the limited authority to do so. I further authorize Herbolution Organics Collective to share their primary caregiver status of my person in order to enter into contracts to obtain and/or allow growth/preparation of medication and edibles for my benefit. As a member, I understand that Herbolution Organics Collective, has other members with similar membership agreements.
I hereby authorize Herbolution Organics Collective, to jointly possess the medicinal marijuana as described under this agreement jointly with other Hebolution Organics Collective members under similar membership agreements. I agree the medicinal marijuana possessed by Herbolution Organics Collective at any time is the collective property of every patient who is also under this membership agreement and the care of Herbolution Organics Collective. I agree to provide Herbolution Organics Collective with all changes in my contact information, diagnosis, or primary physician immediately. I hereby consent to the benefits provided by Herbolution Organics Collective. I understand that Herbolution Organics Collective has made no efforts in encouraging me to produce or use any substances for my medical condition. I have been informed by an authorized representative of Herbolution Organics Collective that I should continue to seek professional medical advice prior to and during my use of any cannabis product I may acquire through Herbolution Organics Collective.
I understand that Herbolution Organics Collective was organized to fill the necessity of medical cannabis. I further understand that circumstances may require defense of authorization in a court of law and agree to participate in such defense to the extent necessary and practicable. I understand that Herbolution Organics Collective reserves the right to refuse service(s) to members. I affirm that I am above eighteen (18) years of age or have the consent of my parent/guardian, and that I have medical condition(s) as attested to on my information form. I understand that my contributions to Herbolution Organics Collective, through products I may acquire through the organization, are used to unsure continued operation of the Herbolution Organics Collective and that this transaction, in no way, constitutes commercial promotion. I understand that medical marijuana, while being a well-known effective therapeutic agent, is still illegal in this country. Therefore, by initialing and agreeing to this form, all members Herbolution Organics Collective are committing an act of federal civil resistance. I authorize the Herbolution Organics Collective, to acknowledge the fact of my membership, when needed, for the preservation of my medical rights under the compassionate use act of 1996.
DISCLAIMER – GENERAL RELEASE, INDEMNIFICATION AND HOLD HARMLESS CLAUSE
I, the patient, being of lawful age and sound mind, do now release, acquit, and forever discharge Herbolution Organics Collective herein referred to as owner, of Herbolution Organics Collective, from all actions, claims, demands, or damages accruing to me from any known or unknown injury, loss, or damage sustained by or to me. This release shall remain in force and run concurrently with my membership in Herbolution Organics Collective. In witness whereof, I have executed this release in California. I further agree to indemnify and hold harmless Herbolution Organics Collective from any injuries or damages resulting from the use or misuse of medical marijuana obtained from Herbolution Organics Collective.