Amazonia Moyano Liability Waiver

I HEREBY AGREE AND ACKNOWLEDGE THAT BY BOOKING MY STAY WITH AMAZONIA MOYANO HEALING CENTER CENTRO DE MEDICINA ANCESTRAL (RIDER AREVALO), I  ASSUME ALL OF THE RISKS OF PARTICIPATING IN ANY/ALL ACTIVITIES ASSOCIATED WITH THIS EVENT, I certify that I am physically fit, have sufficiently prepared or trained for participation in this activity, and have not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems that preclude my participation in this activity and that I have filled out the medical questionnaire truthfully and acknowledge that there are contraindicated substances which I have informed said persons and entities thoroughly.  I acknowledge that this Accident Waiver and Release of Liability Form will be used by the event holders, sponsors, and organizers of the activity in which I may participate and that it will govern as the contract between me and AMAZONIA MOYANO HEALING CENTER CENTRO DE MEDICINA ANCESTRAL (RIDER AREVALO) and my actions and responsibilities at said activity. I understand that I will be respectful and courteous during my stay at AMAZONIA MOYANO HEALING CENTER CENTRO DE MEDICINA ANCESTRAL (RIDER AREVALO) and that I will follow all rules and regulations set forth during the duration of my stay including but not limited to, quiet time between set hours, courtesy toward other guests, and that failure to follow the rules set herein will result in my being asked to leave and that AMAZONIA MOYANO HEALING CENTER CENTRO DE MEDICINA ANCESTRAL (RIDER AREVALO) reserves the right to refuse service to anyone and a refund will not be issued. In consideration of my application and permitting me to participate in this activity, I hereby take responsibility and action for myself, my executors, administrators, heirs, next of kin, extended family, successors, partners, employees, representatives, and assigns as follows: (A) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this activity. I understand I am traveling to a foreign country and it is my responsibility to purchase health insurance while traveling to the event and that AMAZONIA MOYANO HEALING CENTER CENTRO DE MEDICINA ANCESTRAL (RIDER AREVALO) will not be held responsible for any health-related concerns requiring the attention of a medical professional, nor will they be held responsible for the payment of flights to and from the center, or for the reimbursement of delayed or canceled flights. AMAZONIA MOYANO HEALING CENTER CENTRO DE MEDICINA ANCESTRAL (RIDER AREVALO) is not responsible for civil unrest, political unrest, terrorism, or other situations that may arise during the time I am in the foreign country.   THE FOLLOWING ENTITIES OR PERSONS: AMAZONIA MOYANO HEALING CENTER CENTRO DE MEDICINA ANCESTRAL (RIDER AREVALO) INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this activity, whether caused by the negligence of release or otherwise. I acknowledge and unconditionally release and forever discharge any persons, entities, and their respective directors, officers, employees, agents, contractors, volunteers, partners, shareholders, successors, assignees, parent or subsidiary entities, or representatives, are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity conducting a specific activity on their behalf. I acknowledge that this activity includes drinking an entheogenic brew and may involve a test of a person's physical and mental limits and carries with it the potential for death, serious injury, and property loss. The risks include, but are not limited to, hallucinations, emotional changes, tremors, dilated pupils, increased blood pressure, nausea, and vomiting, physical changes, and changes in mental state. These risks are understood and I acknowledge I have researched and willingly subject myself to any and all risks that may be present during the activity. I hereby consent to receive treatment that may be deemed advisable in the event of injury, accident, and/or illness during this activity.

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I understand that AMAZONIA MOYANO HEALING CENTER CENTRO DE MEDICINA ANCESTRAL (RIDER AREVALO) does not promise to cure any diseases or mental illnesses of any kind and I release any liability and hold harmless the entities or persons mentioned in this paragraph should I experience any mental changes, emotional distress/changes, and physical discomfort during or after the participation of this event.

 

I understand while participating in this activity, I may be photographed. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose by the activity holders, producers, sponsors, organizers, and assigns. The Accident Waiver and Release of Liability Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under Peruvian applicable law. I CERTIFY THAT I HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND UPON MY BOOKING WITH AMAZONIA MOYANO HEALING CENTER CENTRO DE MEDICINA ANCESTRAL (RIDER AREVALO) THAT THE TERMS ARE BOUND.

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*if you wish not to be photographed, please let us know and we will accommodate your request