Kuntanawa Hapé Circle & Indigenous Workshop in Scottsdale, AZ

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Kuntanawa Hapé Circle & Indigenous Training in Scottsdale, AZ

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2 Price

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4 Client Information

Date of Birth
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Comments or Special Needs *
How did you hear about us? *
Terms and Conditions *	I accept the terms and conditions. I have read, understand and agree to the Spiritual Diet, Contraindications, Terms and Conditions, Code of Conduct and Sexual Integrity Agreement for attending this Kuntanawa Event. Please read the terms and conditions
The price reflects your donation for the experience. I understand all plant medicines offered are a gift from the tribe with my donation for the experience. *	I understand all plant medicines offered are a gift from the tribe with my donation for the experience.
Country *
Do you have a spiritual practice? If so, please describe. *

5 Private Ministerial Association KUNTANAWA NATION MEMBERSHIP

MEMBERSHIP APPLICATION	KUNTANAWA NATION - A Private Ministerial Association By joining Kuntanawa Nation, a Private Membership Association and/or any website or Social Media Group started by, created by, maintained, or organized by the Association, I agree to the terms and conditions of Kuntanawa Nation, a Private Membership Association, Agreement as follows. This Association of members declares that our objective is to allow the Private Membership Association founders and all Private Membership Association members with a platform in which to conduct all manner of private business with the Association and with other Associations and Association members, keeping all business in the private domain and utilizing the protections guaranteed by the Universal Declaration of Human Rights (UDHR), the Constitution to conduct business in private and to provide a platform for members to conduct business in the private domain under all protections acknowledged and guaranteed by the Constitution of the UNITED STATES, and any previous protections guaranteed. We believe that the Holy Scriptures, the Universal Declaration of Human Rights (UDHR), the Constitution of the United States of America, the various constitutions of the several states of the union, and the Charter of Rights of Canada guarantees our members the rights of absolute freedom of religion, free speech, petition, assembly, and the right to gather together for the lawful purpose of helping one another in asserting our rights protected by those Constitutions, Charter and Statutes, in addition to the rights to be free from unreasonable search and seizure, the right to not incriminate ourselves, and the right to freely exercise all other unalienable rights as granted by our creator, our almighty God and guaranteed by those Constitutions, Charter, and Statutes. WE HEREBY Declare that we are exercising our right of “freedom of association” as guaranteed by the Universal Declaration of Human Rights (UDHR), the U.S. Constitution and equivalent provisions of the various State Constitutions, as well as the Charter of Rights of Canada. This means that our Association activities are restricted to the private domain only and outside of the jurisdiction of government entities, agencies, officers, agents, contractors, and other representatives as provided by law. We declare the basic right of all of our members to decide for themselves which Association members could be expected to give wise counsel and advice concerning all matters including, but not limited to physical, spiritual, and mental health care assistance, law, and any other matter and to accept from those members any and all counsel, advice, tips, whom we feel are able to properly advise and assist us. We expect the freedom to choose and perform for ourselves the types of therapies and treatments that we think best for diagnosing, treating and preventing illness and disease and for achieving and maintaining optimum wellness, as well as the freedom to choose for ourselves any types of assistance which may be made regarding law and any other private business activity. The mission of this Association is to provide members with a forum to conduct business between members in the private domain with the protections guaranteed within the aforesaid Constitution and Charter remaining fully intact. The Association will recognize any person(s), natural or otherwise (irrespective of race, color, or religion) who have joined this Association or any social media group organized, created, or managed by this Association and is in agreement with these principles and policies as a member of this Association, providing said person has not been sanctioned, exercised, or otherwise banned by the association, and will provide a medium through which its individual members may associate for actuating and bringing to fruition the purposes heretofore declared. Membership to this Association, "Kuntanawa Nation", and any of its groups may be terminated by the association Trustees or their designee, at any time, should they conclude that a specific member is interacting with them or any other members in a way that is contrary or detrimental to the focus, principles, and betterment of this Association. I understand that, since The Association is protected by the First and Fourteenth Amendments to the U.S. Constitution, it is outside the jurisdiction and authority of Federal and State Agencies and Authorities concerning any and all complaints or grievances against The Association members or other staff persons. All rights of complaints or grievances will be settled by an Association designee, committee, or tribunal and will be waived by the member for the benefit of The Association and its members. By agreeing to this membership form I agree that I have sought sufficient education to determine that this is the course of action I want to take for myself. I agree to join Kuntanawa Nation, a private membership association under common law, whose members seek to help each other achieve better health and good quality of life. A. I am voluntarily changing my capacity from that of a public person to that of a private member. My activities within The Association are a private contractual matter that I refuse to share with the Local, State, or Federal investigative or enforcement agencies. I fully agree not to pursue any course of legal action against a fellow member of The Association, unless that member has exposed me to a clear and present danger of substantive evil, and upon the recommendation and approval of the Association I enter into this agreement of my own free will without any pressure or coercion. I affirm that I do not represent any Local, State or Federal agency whose purpose is to regulate and approve products or services, or to carry out any mission of enforcement, entrapment or investigation. I have read and understood this document, and my questions have been answered fully to my satisfaction. I understand that I can withdraw from this agreement and terminate my membership in this association at any time, and that my membership can and will be revoked if I engage in abusive, violent, menacing, destructive or harassing behavior towards any other member of The Association. These pages consist of the entire agreement for my membership in The Association.
Membership Agreement *	I agree this contract began on the date of my joining "Kuntanawa Nation". I declare that by joining this Association and/or the Associations websites and/or social media group(s), I have carefully read the whole of this document above and I understand and agree with it.
DATE *

6 Safety, Disclosures and Privacy Agreements

Agreement 1 *	I have read and understood the above contraindications. I understand that taking other drugs or herbs may be harmful to my health. If I need to stop a prescribed medication I will ensure it is done safely and consult my physician if needed.
Agreement 2 *	You agree that you are in physical and mental condition appropriate to the activities described in the event, that you agree to participate at your own risk, and that we cannot accept liability for any accident or injury.
Agreement 3 *	Nondisclosure Agreement: By participating in this event you agree that you will not disclose the identities or actions conducted by any participant during the event without their expressed permission.
Agreement 4 *	Please indicate this form was filled out honestly and to the best of your ability.
Photo Release Agreement *	By checking this section, I acknowledge that I have completely read and fully understand the above release and agree to be bound thereby. I hereby release any and all claims against any person or organization utilizing these materials for entertainment purposes.
Photograph & Video Release	I hereby grant permission to the rights of my image, likeness and sound of my voice as recorded on audio or videotape without payment or any other compensation. I understand that my image may be edited, copied, exhibited, published, or distributed and waive the right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of my image or recording. By signing, I understand this permission signifies that photographic or video recordings of me may be electronically displayed via the Internet or in the public educational setting. I will be consulted about the use of the photographs or video recording for any purpose other than those listed above. There is no time limit on the validity of this release nor is there any geographic limitations on where these materials may be distributed. This release applies to photographic, audio or video recordings collected as part of the sessions listed on this document only.
DATE *

7 Accident Waiver Release of Liability Form

Waiver Agreement 1 *	I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING OR ATTENDING THIS ACTIVITY OR EVENT, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by the event, or because of their possible liability without fault. I certify that I am physically fit and have completed the medical questionnaire and/or have not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems which preclude my participation in this activity or event. I acknowledge that this Accident Waiver and Release of Liability Form will be used by the event holders, sponsors, and organizers of Kuntanawa, and that it will govern my actions and responsibilities at said activity or event. In consideration of my application and permitting me to participate in this event, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows:
Waiver Agreement 2 *	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 event.*
Waiver Agreement 3 *	INDEMNIFY, HOLD HARMLESS, AND WILL NOT TO SUE the entity and/or persons organizing this event and waive them from any and all liabilities or claims made as a result of participation in this activity or event, whether caused by the negligence of release or otherwise. I acknowledge that this activity or event may test a person’s physical and mental limits and may carry with it the potential for death, serious injury, and property loss. The risks may include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of participants, equipment, vehicular traffic, actions of other people including, but not limited to, participants, volunteers, spectators, coaches, event officials, and event monitors, and/or producers of the event, and lack of hydration. These risks are not only inherent to participants, but are also present for volunteers. I am aware that physical activity will increase my risk of hypoglycaemia due to my condition (type 1 diabetes mellitus) and I will ensure that I will take every preventative precaution necessary. I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during this activity or event. I understand that at this event or related activities, I may be photographed. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose by the event holders, producers, sponsors, organizers, and assigns. The accident waiver and release of liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under 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 I SIGN IT OF MY OWN FREE WILL
DATE *
Acknowledgment of Understanding *	I unde4rstand that these services are not a substitute for medical or psychological treatment.
Digital Client Signature *
Date *
What name would you like on your certificate of completion? *
Payments do not include the cost of plant medicines. *	I understand that payments made through Retreat Guru do not include the cost of: plant medicine, psychedelics or similar products. Supplementary Products Exclusion: Participants acknowledge and agree that these Fees presented and payable pertain solely to Services and Offerings, and will not include the cost of any plant-medicines or similar products (collectively, "Supplementary Products") which may be provided, offered, or distributed by a Commercial User, or any other party, in connection with Services or Offerings. Retreat Guru shall bear no responsibility or liability in connection with any provision, offering, or distribution of Supplementary Products, and is not a party thereto. All capitalized terms used herein shall carry the same meaning as assigned to them in Retreat Guru's Terms of Service.

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