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Annual Event Consent, 

Waiver and Release

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PLEASE READ THIS EVENT CONSENT, WAIVER AND RELEASE 

(“RELEASE”) CAREFULLY AND COMPLETELY BECAUSE IT AFFECTS 

YOUR LEGAL RIGHTS. IF YOU HAVE ANY QUESTIONS, PLEASE 

CONTACT THE EVENT LEADER(S). YOUR PARTICIPATION IN THE 

EVENT CONSTITUTES A REPRESENTATION THAT YOU FULLY 

UNDERSTAND THIS CONSENT FORM, EVENT RISK DISCLOSURE, AND THAT YOU WILL FOLLOW THE EVENT PROTOCOLS AND ALL OTHER 

PROTOCOLS OF THE DTMMS AND EVENT LEADER(S).

I am the Participant named above.*Remove

In consideration of the Deer Tribe Metis Medicine Society (“DTMMS) 

and all affiliated and non-affiliated entities and individuals sponsoring or organizing the event, including but not limited to Matthias and Colette Pfeiffer ("Event Leaders(s)") granting me permission to participate in the Event listed above, I agree to the following:

  • I have received, read, and understand the Event Risk Disclosure (“Event Disclosure”) for the Event. I have voluntarily registered for the Event expressly assuming all risks associated with participating in the Event, including those disclosed in the Event Disclosure.

  • I have received the Event Protocol for the Event. I specifically agree to uphold and to follow the Event Protocol, as well as any additional protocols that may be issued or posted before or during the Event by DTMMS, the Event Leader(s), or any other person designated by DTMMS or Event Leader(s) to provide such instructions. I agree that, by implementing the Event Protocol, DTMMS and Event Leader(s) have acted reasonably and have taken all steps that I expect anyone to take to mitigate risk to my safety as a participant in the Event. I further specifically agree I am personally solely responsible for taking all additional steps necessary or appropriate to guarantee my own safety and my own physical, emotional, and mental well-being before, during, and after the Event.

  • I understand that DTMMS and Event Leaders do not engage medical or safety professionals to oversee the planning, directing, or facilitating of the Event and that risks associated with my participation may not be fully disclosed in the Event Disclosure. I agree to assume all disclosed and undisclosed risks associated with my participation in the Event.  I hereby waive any and all legal rights to make any statutory, common law, or other claim relating to my safety as a participant in the Event and I release and hold harmless (collectively and individually): DTMMS, Event Leader(s), DTMMS and Event Leader(s) officers, board of directors, employees, agents, affiliates (including lodges), independent contractors, and volunteers; property owners and managers of the Event location, other entities or individuals involved either directly or indirectly in any capacity, in the planning, directing, hosting, facilitating, or merely participating in or present before or during the Event (collectively the “Event Group”).

  • I am not presently aware of, nor have I ever been, advised by a doctor that I have any physical, mental, emotional, or psychological condition(s) which would prevent me from participating in the Event. I recognize and agree that the activities of the Event are not in accordance with generally accepted standards of the healthcare industry (for medical, psychological, physical, mental, and emotional providers of healthcare and mental health services), nor are they a treatment for any physical, emotional, psychological, or mental disease, illness or malady. I further represent that I am not participating in the Event as a substitute for professional treatment of any physical, mental, emotional, or psychological issues.

  • I am responsible for performing my own health and wellness self-assessment screening (“Screening”) prior to the Event and for 

    personally monitoring my own health throughout the Event. I agree not to participate in the Event to the extent my Screening identifies a counter-recommended risk set forth in the Event Disclosure and agree to remove myself voluntarily from the Event if, at any time, I believe removal is required to prevent unreasonable risk to myself or to others. I attest that I have fully disclosed all pre-existing emotional, mental, or physical conditions to the Event Leader(s) that I have assessed may affect my participation in the Event, and have arranged with Event Leader(s) any modifications to my participation that I have determined necessary to maintain my safety or the safety of others. I agree to immediately inform DTMMS and Event Leader(s) about any concerning or unsettling physical, emotional, mental, or psychological irregularities, including any physical sensation or mental discomfort, which I may experience during the Event. DTMMS and Event Leader(s) shall have the right, but not the obligation, to discontinue my participation.

  • I understand that this Release is a voluntary and intentional relinquishment of all known and existing rights that I may have to make any legal claims against DTMMS, the Event Leader(s), or the Event Group arising out of my participation in the Event.

  • I am not presently under the treatment or supervision of any healthcare professional for any disease or physical, mental, or emotional disorder or, if I am under such treatment, I have determined that such condition will not affect my participation in the Event. I agree I will not possess nor act under the influence of any unlawful substance, or any drug or alcohol during the Event, except medication which I am required to take by my physician. I attest that any such medication does not impair my mental, physical, or emotional ability to understand and experience physical and mental stimuli. I further agree I will not be under the influence of any painkiller, anesthetic, hallucinogen, alcohol, or drug other than the foregoing described medication.

  • To the best of my knowledge, I represent and warrant that I have no disease or other condition that is likely to spread to others because of my participation in the Event.  I agree that if, subsequent to the Event, I learn that I have a disease or other condition that I may have spread to others during the Event (for example, if I test positive for COVID-19  within two weeks after the Event), that I will inform DTMMS and Event Leader(s) so that they can notify other participants of possible exposure.

(please write None or identify agency). If I have indicated I am such an employee I represent and warrant that I am not attending the Event in any official capacity and will not report or disclose the events at the workshop to my employer.

 

WAIVER AND RELEASE

By signing this Release, I intend to bind my spouse or legally recognized domestic partner, heirs, legal representatives, assigns, insurers, and anyone else claiming under me. I understand and acknowledge that as to claims, whether known or unknown, including any statutory provisions that would otherwise apply to limit this Release are hereby waived. **Further, if I am signing this release on behalf of a minor, as that term is defined by the law of the jurisdiction in which the activity is taking place, I acknowledge and agree that I am the legal parent and/or legal guardian for that minor.

I acknowledge and represent that I am at least the minimum age required to make this Release legally binding. 


I further acknowledge and represent that in executing this Release and Waiver I have not relied on any inducements, promises, or representations made by DTMMS, the Event Leader(s), or the Event Group. If any provisions of this agreement are found to be void and/or unenforceable the remaining provisions shall remain in full force and effect.

I AGREE THAT ANY CAUSE OF ACTION, CONTROVERSY OR CLAIM 

ARISING OUT OF OR RELATED TO THE EVENT BETWEEN THE EVENT 

GROUP AND ME, MY SPOUSE OR LEGALLY RECOGNIZED DOMESTIC 

PARTNER, HEIRS, LEGAL REPRESENTATIVES, ASSIGNS, INSURERS, AND ANYONE ELSE CLAIMING UNDER ME OR AS TO THE 

CONSTRUCTION, INTERPRETATION AND EFFECT OF THIS RELEASE 

SHALL BE SETTLED BY ARBITRATION PURSUANT TO THE APPLICABLE RULES OF THE AMERICAN ARBITRATION ASSOCIATION. THE ARBITRATION SHALL TAKE PLACE AT AT LOCATION DESIGNATED BY THE EVENT LEADER(S). HOWEVER, PRIOR TO ARBITRATION I AGREE TO FOLLOW ALL APPLICABLE DTMMS DISPUTE RESOLUTION PROCEDURES (IF ANY) THEN IN EFFECT. I HEREBY WAIVE ANY RIGHT TO A JURY TRIAL.

Hawks Cry Lodge
Boulder CO

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