Training Registration Agreement 2018

Medicinal Mindfulness

Psychedelic Sitters School

Training Registration Agreement 2018 v1

PLEASE NOTE: If you are flying in from a lower elevation, please drink plenty of water, electrolytes and stay hydrated!

Core Training Workshops offered in 2018

Psychedelic Sitters School (5 Days - Wednesday Evening to Sunday)
Community Breathwork Facilitation (4 Days - Thursday to Sunday)
Psychedelic Guiding with Cannabis Sativa (4 Days - Thursday to Sunday)
DMTx Psychonaut Training Retreat and Community Gathering

Tuition
Tuition fees are based on type of program. Students and Veterans automatically receive the scholarship rate. Email us to apply for our needs based scholarship.

Other Costs
The training is held at a private residence in Boulder, CO. Participants are required to take care of their own travel, food and lodging needs. Ask us about hotel and AirBnB options. Medicinal Mindfulness provides ample snacks and one shared community meal. Usually participants bring their own lunches and dinners and organize one shared potluck meal.

Designated Driver Required
PLEASE NOTE: If you drive yourself to the event or do not have a designated driver, we will help you schedule a cab. You will be unable to use cannabis at the event without a pre-arranged ride from this event. Ridesharing: www.uber.com & www.lyft.com Local Taxi: www.zTrip.com (303)699-8747 - Taxi service pick ups can be scheduled prior to event.

The information listed in the Designated Driver Field is accurate and I will not drive myself home from this event, nor drive again before completely sober.

Certificates of Completion and Certification
Trainees that complete the weekend training will receive certificates of completion. Level 1 Psychedelic Sitters School is a prerequisite for other trainings as well as our sitter and facilitator certification program. Medicinal Mindfulness is offering one certification beginning in 2018: Certified Psychedelic Sitter (CPS). The CPS certifies that you have a certain amount of sitter training and agree to important code of ethics requirements.

Registration Instructions
A $100 deposit is required to begin the application process for the first class. Email events@medicinalmindfulness.org and you will receive an invitation for a brief interview and an electronic invoice for the deposit. Once approved, a non-refundable half tuition payment is required to reserve your space for a particular training date. Final payment is due 1 month before class begins.

Due to limited space and the small class sizes, you are reserving your spot even if you don’t show up. Refunds are only issued in extenuating circumstances. With written email notice of one month to first day of class, the full tuition or deposit can be transferred to credit for other training dates or MM services. With 2 weeks notice, half of the tuition is transferred, and the other half is used to cover the cost of an empty position. With less than two weeks notice, the full tuition is abdicated by the trainee. Before paying the first half of the tuition deposit, please confirm that the dates work on your end. The initial $100 deposit can be used for any training of 2018.

Please review the Safety Self-Assessment, participation waivers for both the Conscious Cannabis Events and Community Breathwork, the Logistics and Welcome Letter, and the Medicinal Mindfulness Safe Community Policy (currently being drafted) before applying to ensure the training is a good fit.

The initial deposit of $100 is required to apply and to cover the cost of a 30 minute interview and safety review process. If selected, the deposit is applied to your tuition. This is for safety and security purposes. Please review the Safety Self-Assessment to determine your readiness to attend the program before this interview. If after the interview it is determined that this training isn't a good fit at this time, you will be provided with recommendations for next steps and refunded half ($50) of your $100 initial deposit. The reminder is kept to cover the cost of the interview process. The interviewer is paid either way to ensure objectivity.

Psychedelic Sitters School is a psychedelic and cannabis harm reduction program and complies with all applicable Colorado laws related to cannabis use. Must be 21 years old or older to attend. Consuming cannabis is completely optional.

Training Participation Agreement
Medicinal Mindfulness is committed to making safe and skillful journeywork and guidework practices as accessible as possible. Becoming skillful in our journey, sitting and guiding techniques takes time and a lot of practice. In addition to this, because of the spiritual or transpersonal nature of our work, we are required to go through our own healing and awakening process, often in ways we didn’t know before we began. These can be big experiences for our students and members. For this reason, we have created a “stepping into” process, levels of training and competence that each have requirements and intentional commitments. We do this for safety reasons, not as a way to limit our members or students in any way.

The Psychedelic Sitters School is an introduction experience and is a harm reduction training program. It is a first step, not a completion. In no way does it adequately prepare people to be sitters or guides in ALL of the situations that a sitter or guide will encounter. The Sitters School is designed to be done in conjunction with ongoing supervision sessions and/or the ongoing training where members receive hands on experience by being a student sitter at our events. In addition to this training, people who become advanced facilitators and guides also have additional training and experience in the form of first aid training, counseling degrees, massage therapy degrees and other professional skill sets.

We take this work very seriously and are committed to supporting our students in reaching the highest level of training and skill that they want to. This takes time. Under no circumstances can our students represent our work adequately in public settings, or the teachings without first going through a significant period of training and skill set development and experience with our program. By participating in this program, you agree to take your time with this process and to not place yourself in situations that are above your ability and competence. Knowing your limitations and gifts takes time and can be explored with your teacher at Medicinal Mindfulness. Facilitating your own groups or individual experiences in unsupervised contexts can cause harm to yourself and others. There’s too many nuanced factors to understand and develop skillful responses around to be learned from just a few experiences.

We want you to succeed. And we have developed a training program based on grounded theory and a lot of experience on how to do that. If you have any questions regarding expectations and requirements please ask.

Assumption of Risk
In consideration of the services of Medicinal Mindfulness LLC & Medicinal Mindfulness Events LLC affiliates: Daniel McQueen and training assistants, their agents, owners, officers, volunteers, participants, employees, and all other persons or entities acting in any capacity on their behalf (hereinafter collectively referred to as MM), I hereby agree to release and discharge MM, on behalf of myself, my children, my parents, my heirs, assigns, personal representative and estate as follows:

Emotional Risk:

I acknowledge that I understand this is a professional training, which includes self-reflection, interactive exercises, time outdoors, and professional growth. I acknowledge that I have choice about the level of my participation at all times and that, although personal material may arise for me within the context of the training, this is not therapy, and I am responsible for my own well-being. If I feel the need arises for therapy, I will take action accordingly or request the appropriate resources.
I am aware that participants are asked to hold confidentiality of personal material disclosed in the training, but this cannot be guaranteed.
I understand that a MM training is intended as a personal growth experience and should not be used as a substitute for psychotherapy or medical treatment.
I understand that a MM training could involve dramatic experiences accompanied by strong emotional and physical release as outlined in the CCE Participation Agreement.

Physical Risk:

I have read the Conscious Cannabis Experience participation agreement and the Community Breathwork participation agreement and acknowledge the inherent risks in participating.
I certify that I have adequate health insurance to cover any injury or damage I may suffer while participating, or else I agree to bear the costs of such injury or damage myself. I further certify that I am willing to assume the risk of any medical or physical condition I may have.

General:

I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless MM from any and all claims, demands, or causes of action, which are in any way connected with my participation in this activity or my use of MM's equipment or facilities, including any such claims which allege negligent acts or omissions of MM
I expressly agree and promise to accept and assume all of the risks existing in this activity. My participation in this activity is purely voluntary, and I elect to participate in spite of the risks.
Should MM or anyone acting on its behalf, be required to incur attorney's fees and costs to enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs.
In the event that I file a lawsuit against MM, I agree to do so solely in the state of Colorado, and I further agree that the substantive law of that state shall apply in that action without regard to the conflict of law rules of that state. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect.

By signing this document, I acknowledge that if anyone is hurt or property is damaged during my participation in this activity, I may be found by a court of law to have waived my right to maintain a lawsuit against MM on the basis of any claim from which I have released them herein.

Conscious Cannabis Events Safety Self-Assessment 2018 v8
Please read and answer the Safety Self-Assessment before your interview with a Medicinal Mindfulness facilitator. While cannabis is legal in Colorado to possess and consume in certain contexts, and is used recreationally and safely by millions of people, Conscious Cannabis Events (CCEs) are transformational experiences that are more akin to meditation retreats and other entheogenic practices.

In case of emergency, I understand that effort will be made to secure proper treatment. I hereby give permission for such treatment. My personal health and accident insurance covers any accident or illness that I may incur during this experience and I will personally guarantee any cost or other liability incurred during evacuation or treatment. I have read the description of the program and information provided for preparation and understand the nature of the program and risks involved.

I have reviewed the Safety Self-Assessment. By signing this form and by attending the Training Event, I certify that that I am physically, mentally, emotionally and spiritually fit enough to safely participate. I also acknowledge that I can speak with a Medicinal Mindfulness facilitator about any safety concerns before attending the training.

Disclosure Statement Acknowledgement
I have read this document and requirements for being a student of Medicinal Mindfulness and agree to comply with these expectations.

Please select who will be participating...

Adult Minor(s)
1 Minor 2 Minors 3 Minors 4 Minors 5 Minors More Minors 6 Minors 7 Minors 8 Minors 9 Minors 10 Minors

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First Participant's Name

First Name*

Last Name*

Phone*

First Participant's Date of Birth*

First Participant's Signature*

Second Participant's Name

First Name*

Last Name*

Second Participant's Date of Birth*

Third Participant's Name

First Name*

Last Name*

Third Participant's Date of Birth*

Fourth Participant's Name

First Name*

Last Name*

Fourth Participant's Date of Birth*

Fifth Participant's Name

First Name*

Last Name*

Fifth Participant's Date of Birth*

Sixth Participant's Name

First Name*

Last Name*

Sixth Participant's Date of Birth*

Seventh Participant's Name

First Name*

Last Name*

Seventh Participant's Date of Birth*

Eighth Participant's Name

First Name*

Last Name*

Eighth Participant's Date of Birth*

Ninth Participant's Name

First Name*

Last Name*

Ninth Participant's Date of Birth*

Tenth Participant's Name

First Name*

Last Name*

Tenth Participant's Date of Birth*

Participant's Address

Address Line 1:*

Street address, P.O. box, company name, c/o

Address Line 2:

Apartment, suite, unit, building, floor, etc.

Country:*

City:*

State/Province:*

Zip/Postal:*

Parent or Guardian's Email Address

Check to receive information, news, and discounts by e-mail.

A signed copy of this waiver will be sent to the email address you provide.

Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*

Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.

Parent or Guardian's Name

First Name*

Last Name*

Phone*

Parent or Guardian's Date of Birth*

Parent or Guardian's Signature*

Electronic Signature Consent*

By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.

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