ACKNOWLEDGMENT, LIABILITY RELEASE AND INDEMNITY AGREEMENT
General Provisions
This Acknowledgement, Liability Release and Indemnity Agreement (“Agreement”) is voluntarily entered into between the undersigned individual (“Participant”) on one side and Church of the Mother Goddess and Boulder Country Retreat Center on the other side (collectively referred to herein as “Church”). This Agreement is intended to cover all activities by Participant with Church as described below. The Agreement is effective as of the date signed below.
Church is a spiritual community created to help individuals find enlightenment and connect with God, the divine source of all creation. Through communion with our creator with the assistance of our Sacraments, we gain a deeper understanding of the meaning of life and strive to live in harmony with our environment, with our families, with our community and to live and uphold moral principles. We hold that the sacred sacraments MDMA, psilocybin, and 5-MEO-DMT have long been used across spiritual traditions as rites of communion with the divine. We recognize our Sacraments as divine teachers and guides that are an essential element of our path toward spiritual path. Only through their sincere religious use can participants understand the moral, ethical, and spiritual wisdom and psychospiritual healing these Sacraments teach us. Our Sacraments allow members and participants to understand the spiritual values reflected in this Statement of Beliefs.
Participant acknowledges and accepts Church has agreed to provide certain services including spiritual guidance, coaching, harm reduction services, beneficial community-based use and healing, supported use, or other related services related to Participant’s spiritual use of our Sacraments (“Services”). Church is not providing any mental health or medical treatments or therapies related to this Agreement.
Church operates with a good faith belief that its practices are protected by state and federal law in the United States, including but not limited to the federal Religious Freedom Restoration Act and each state’s religious freedom provisions of its state Constitution or statutes. A copy of our spiritual principles has been separately provided to the Participant. Participant’s activities related to is Sacraments, if done in alignment with Church’s spiritual beliefs may also create protections for you under state and federal law; however, we note that each state’s laws are unique and you are required to review your own state law to determine any protections it provides. Church is not responsible for any negative consequences if Participant’s activities are not protected by their own state laws.
Boulder Canyon Retreat Center is a harm reduction organization focused on supporting the Participant with the spiritual work conducted by the Church through preparation, harm reduction during ceremonies, and integration after ceremonies. In addition, Boulder County Retreat Center will provide other retreat services including food, lodging, and activities other than those involving the Sacrament. Boulder County Retreat Center is not being paid in any way related to the spiritual work of the Church.
Participant understands that the use of our Sacraments may be transformational and may create positive changes in my spiritual wellbeing, mood, habits, and emotional state if engaged in with intention. However, Participant understands and acknowledges that there are also risks associated with engaging in the use of our Sacraments, as discussed throughout this Agreement. Participant understands that Church cannot and does not guarantee any particular outcome from Participant’s use. Participant acknowledges that they should seek independent medical advice from a qualified professional to determine if they are medically cleared to engage in activities related to the use of our Sacraments.
Dimethyltryptamine (“DMT”) Side Effects and Warnings
The main effect of DMT, one of the active ingredients in 5-MEO-DMT, can include intense visual and auditory hallucinations, euphoria, and an altered sense of space, body, and time. Many users describe profound, life-changing experiences such as visiting other worlds, talking with alien entities, and total shifts in the perception of identity and reality. When smoked, DMT produces brief yet intense visual and auditory hallucinations that some users describe as an alternate reality, otherworldly, or a near-death experience. Possible side effects of DMT include: increased heart rate, increased blood pressure, chest pain or tightness, agitation, dilated pupils, rapid rhythmic movements of the eye, and dizziness. When taken orally, DMT can cause nausea, vomiting, and diarrhea. Because DMT can mimic a near-death experience, some people may find using the drug traumatic and upsetting. Mental side effects may linger for many days or weeks after ingestion of the drug.
DMT could have serious adverse consequences for users with pre-existing psychological problems or a mental illness, such as schizophrenia. Pregnant women should not use DMT due to possible negative effects on the fetus. Some drug interactions to watch for and investigate include: (a) antidepressants like SSRIs; (b) MAOIs; (c) antipsychotic drugs; (d) blood pressure medicines; (e) stimulants; and (f) opioids.
Psilocybin side effects and warnings
The effects of psilocybin mushrooms include altered perception of time and space and intense changes in mood and feeling. Other possible effects of psilocybin include: euphoria, peacefulness, spiritual awakening, derealization, or the feeling that surroundings are not real, depersonalization, or a dream-like sense of being disengaged from surroundings, distorted thinking, visual alteration and distortion, such as seeing halos of light and vivid colors, dilated pupils, dizziness, drowsiness and yawning
impaired concentration, muscle weakness, lack of coordination, unusual body sensations
nausea and vomiting, paranoia, confusion, frightening hallucinations, and other physical, mental, and emotional effects. The effects of psilocybin vary between people, based on the user’s mental state, personality, and immediate environment.
It may be unsafe for people with the following conditions to take psilocybin mushrooms: (a) Psychosis. It may be unsafe for people diagnosed with psychosis, schizophrenia, bipolar 1 or 2 disorder, or similar mental health conditions to use psilocybin. (b) Heart problems. Psilocybin could be risky for people with high blood pressure or other types of heart disease. (c) Pregnancy or breastfeeding. Psilocybin’s effects on pregnancy or breastfeeding are unknown and should be avoided. (d) Medication use. Psilocybin-containing mushrooms are not recommended for people taking certain medications, which can alter the effects of hallucinogenic substances. Some examples include: Lithium (a drug treating bipolar disorder), Tricyclic antidepressants such as amitriptyline (Elavil), Haloperidol, an antipsychotic medication, Selective serotonin reuptake inhibitors such as fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft), Trazodone (Desyrel), Monoamine oxidase inhibitors, such as linezolid (Zyvox) or rasagiline (Azilect), and St. John’s Wort.
MDMA Side Effects and Warnings
MDMA can cause negative health effects, some potentially serious. Using MDMA with some prescription drugs, including selective serotonin uptake inhibitors (SSRIs), may increase the risk of negative health effects. Health risks associated with using MDMA include: (a) Negative health effects of taking MDMA may include higher blood pressure, involuntary jaw clenching, nausea, vomiting, and restless legs. Long-term MDMA use can also lead to heart problems or liver damage; (b) Studies have shown that people who regularly use MDMA may experience poor sleep, a lack of appetite, confusion, depression, anxiety, paranoia, and memory or attention problems; (c) Only a few studies have examined the effects of prenatal MDMA exposure, but evidence suggests that children born to people who took MDMA during pregnancy had an increased risk of birth defects, including heart problems and developmental delays in motor skills like standing and walking; and (d) Some people who use MDMA report symptoms of an MDMA-related substance use disorder. The following prescription drugs may be contraindicated for the use of MDMA: MAO Inhibitors (such as Nardil, Parnate, and Marplan); and drugs metabolized through the same liver enzyme as MDMA (e.g. Ritonivar).
Container Agreements
The participant understands that each group of participants is unique. Participants consent to the following container agreements to help everyone feel safe physically, mentally, and emotionally:
Confidentiality. You will hold in confidence the identities of the other participants and the personal nature of their healing work. You will ask for (sober) permission before taking photos of others at the Event, and before posting them 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.) You will respect the boundaries of others and ask first before delivering hugs, shoulder rubs, etc.
Premises: You agree to stay on the premises for the entire duration of the Event, unless explicitly given permission by an Event Leader. You also agree to stay within the defined ceremony space during medicine-assisted Activities.
Platonic Healing: You 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: You will ask for what you need and speak up when you feel unsafe. You will not participate in Ceremonial Sessions or Activities that you deem to be harmful for your well being.
Safety: You understand that the safety word is “Safety.” When you hear this word, you will immediately stop whatever you are doing, focus, and follow instructions. This is for your own safety, as well as for the safety of others. Likewise, if you deem that something dangerous is occurring during the Activities, you understand that you can likewise call it “safety.”
Personal Growth: You remember that you am here for the purposes of healing and personal growth, and that such processes generally entail confronting parts of yourself and others that may be uncomfortable. You agree that the Church staff may remind you of this throughout the week, and understand that they may call you out when you are deflecting, projecting, or acting out of alignment.
Group Healing: You understand that the healing that happens in groups is different from one-on-one or solo work. You agree to respect the process of other individuals, as it may be quite different than your own. You agree not to touch or speak to other participants during the Ceremonial Sessions.
Judgment: You will be mindful of your own judgment and projections as they arise, and when they do, you will choose kindness.
Attitude of Learning: You understand that there is no such thing as perfection, and that Church staff and other participants may say or do things you dislike. You understand that this is all part of the learning - both yours and theirs.
You understand that failure to abide by these Container Agreements may result in being ejected from the event. Should this occur, you understand that you will not be entitled to any refunds, and that transportation from the event and any expenses incurred as a result of your ejection will be your responsibility. You understand that you will not be removed from the premises of the event if you are under the effects of a psychoactive substance, but that failure to comply with safety instructions may nevertheless result in being removed from the ceremony space to protect others.
Assumption of Risk, Liability Agreement and Hold Harmless Provisions
Participant acknowledges and voluntarily assumes full responsibility for all risks associated with participation, including but not limited to physical, emotional, psychological, or legal risks arising from the use of any Sacrament or related activity. Being fully informed as to risks laid out above and in consideration of the Services, Participant shall forever release, indemnify, and hold harmless Church from any and all claims, counterclaims, damages, defenses, setoffs, recoupments, debts, demands, causes of action, suits, obligations, losses, costs, expenses, and liabilities of any nature whatsoever, in law or in equity, whether known or unknown, fixed or contingent, including but not limited to those arising from your use of our Sacraments or our Services. Participant covenants not to sue Church, or any of Church’s principals, contractors, or agents, and waives any right of recovery, whether known or unknown, that Participant may have to bring a claim or a lawsuit against Church for any personal injury, death, damage to personal property or other injury arising from your use of our Sacraments or the Services, whether arising from a theory of any tort, including negligence, or any other theory in law or equity. This Agreement shall inure to the benefit of any member of the Church’s agents’ family, spouse, heirs, assigns, real property, attorneys and personal representatives. The Agreement shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. In no event shall Church’s liability, if any, exceed the amount paid for the services by the Participant.
Confidentiality & Non-Disparagement
This Agreement is confidential and may not be disclosed by Participant to any third party except as required by any applicable law or valid Court order. Participant shall not make social media or other public posts regarding Church. Participant agrees not to make any disparaging, false, or misleading public statements about Church, its affiliates, or its members.
Miscellaneous
Mediation/Arbitration. Prior to initiating any action under this Agreement, the Parties agree to engage in mediation to resolve any disputes. If any dispute is not resolved by mediation, any remaining dispute, claim, interpretation, controversy, or issues of public policy arising out of relating to this Agreement, including the determination of the scope or applicability of this Section, will be determined exclusively by mandatory binding arbitration held in Denver, Colorado, and will be governed exclusively by the Colorado state Arbitration Act. The Parties waive (i) any right of removal to the United States federal courts and (ii) any right in the United States federal courts to compel arbitration, to confirm any arbitration award or order, or to seek any aid or assistance of any kind. If either party brings an action to enforce the provisions of this Agreement and is the substantially prevailing party in any action, the substantially prevailing party will be entitled to recover its reasonable attorneys’ fees and expenses incurred in such action.
Entire Agreement. This Agreement supersedes all prior discussions and agreements between the Parties and/or their Affiliates with respect to the subject matter hereof and contains the sole and entire agreement between the Parties and their Affiliates with respect to the subject matter hereof.
Waiver. Any term or condition of this Agreement may be waived at any time by the Party that is entitled to the benefit thereof, but no such waiver will be effective unless set forth in a written instrument duly executed by or on behalf of the Party waiving the term or condition. No waiver by any Party of any term or condition of this Agreement, in any one or more instances, will be deemed to be or construed as a waiver of the same or any other term or condition of this Agreement on any future occasion. All remedies, either under this Agreement or by Law, are cumulative and not alternative.
Governing Law. This Agreement is governed by and construed and enforced in accordance with the laws of Colorado, without giving effect to any conflict or choice of law provision that would result in imposition of another state’s law. THE PARTIES WAIVE ANY DEFENSES BASED UPON INVALIDITY OF CONTRACTS FOR PUBLIC POLICY REASONS AND/OR THE SUBSTANCE OF THE CONTRACT VIOLATING FEDERAL LAW.