Everytime Event Risk Disclosure and Health Waiver

PURIFICATION LODGE EVENT RISK DISCLOSURE

A Purification Lodge involves teachings and ceremonies that will encourage you to look at who you are and to take responsibility for who you are. This is spiritual work and may open paths to understanding yourself that may cause you mental, emotional or spiritual distress.

A Purification Lodge involves exposure to heat and high temperatures and humidity in a confined, dark space, in close proximity with other individuals. Some individuals have a risk of experiencing difficulty breathing, increased heart rate, or heat exhaustion. Certain medical conditions may be triggered or aggravated by high heat, humidity, or dehydration. Individuals taking or in withdrawal from certain medications may have adverse reactions to such conditions.

A Purification Lodge involves crowded, dark spaces, which may create a claustrophobic or panic reaction in some participants.

Professional medical personnel are not available at the site of the Purification Lodge. If a participant is in need of medical assistance, professional diagnosis and treatment may not be available.

A Purification Lodge involves the use of fire, hot stones, and water turned to steam, which could cause burn injuries. The humidity and confined space of a Purification Lodge increases the likelihood of spreading certain bacteria, viruses and other diseases. Participation inside the Purification Lodge may require crawling into and out of the Lodge. Participants who experience difficulty with such movement should discuss their limitations and alternatives with their Event Leader(s).

Purification Lodges limited to adult participants may involve nudity. Individuals who are offended by nudity should check with the Event Leader(s) to ensure they are fully informed prior to participation.

Purification Lodge is not recommended (or may be recommended subject to restrictions) for persons suffering from the following, and such persons are advised to consult a medical professional prior to participation:

• Individuals in treatment for or suffering from alcohol or substance abuse;

• Chronic renal failure;

• Diabetes;

• Pregnant individuals;

• Individual recovering from surgery.

A Purification Lodge is not recommended (or may be recommended subject to restrictions) for persons suffering from certain mental illnesses. Participants should disclose and discuss any mental illness with the Event Leader(s) prior to participation.

A Purification Lodge presents a risk of observing the above risks in other participants.

A Purification Lodge is a community activity. The organizers cannot guarantee that all participants will follow the Protocols set for the Purification Lodge.

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PURIFICATION LODGE EVENT PROTOCOLS

(and Election to Participate Outside of the Lodge)

•  Participants are advised to and agree to be responsible to hydrate before, during and after the ceremony.

• Participants are prohibited from consuming alcohol or engaging in recreational drug use prior to or during the Purification Lodge.

• If I need help at any time during the ceremony I am to ask for it.

• If I want to leave the lodge during the ceremony, I am to inform the leader of the purification lodge and I will be assisted to leave safely.

• I will respect the physical space of others and hold their prayers in confidence.

• Participants agree to be responsible for performing a health and wellness self-assessment screening (“Screening”) prior to participating. People with certain health conditions should not participate inside the lodge (see Purification Lodge Event Risk Disclosures).

• *** (edit needed) I will ask any questions I have about the ceremony and my participation in it before... Once my questions have

  been answered to my satisfaction, and I will voluntarily participating in the ceremony.

Medical Disclosure

I hereby disclose the following pre-existing emotional, mental, or physical conditions to the leader of the purification lodge and I acknowledge that it is my responsibility to speak with the leader of the purification lodge about these conditions prior to participating in the purification lodge.

ELECTION TO PARTICIPATE INSIDE/OUTSIDE OF THE 

LODGE OR AS MEMBER OF THE FIRE CREW

Participants who believe that participating inside the lodge may create undue risk should inform the Event Leader(s) and should opt to participate outside the lodge or as a member of fire crew.

ADDITIONAL PROTOCOLS FOR MEMBERS OF FIRE CREW

***can be sent seperately to those who check "as fire crew"?

cannot make final signatures required field for those who are not firecrewing..

• I have been advised that I will be outside for 4-5 hours in possibly extreme weather conditions.

• I have been advised that I will be carrying red hot rocks on shovels.

• I have been advised to wear closed toed leather shoes and non-synthetic clothes (cotton, wool, leather).

• I have been advised to wear, a long sleeved shirt and long pants

• I am expected to respect the physical space of others and to hold the ceremony in confidence.

• I will follow the instructions of the fire chief and adhere to the communicated safety protocols.

• I will only handle hot rocks (pull from fire or carry into lodge) after having received a demonstration of the applicable procedures.

Form: PL20231226/HCL071524