Participation Form

TIGER HYMN
Sacred Medicine Ceremony PARTICIPATION Form

* Indicates required field

Name *

First

Last

Age *

Email *

Your Cell Number *

Cell number for closest kin *

If you are not South African please share which country you are from. *

Do you have an past experiences with sacred plant medicines in ceremony *

This is my first time. I have had a few casual experiences with plant medicines. I have participated in a few ceremonies before. I participate regularly

Which plant medicines have you experienced? Please indicate if you had any challenges or difficulties with any of them. *

Are you taking any kind of medication? If yes, please explain which ones and what is it for. It is important that you disclose all medications you are using including holistic, herbal medicines or supplements. *

Are there any mental or physical conditions or concerns that we need to be aware of? *

What is your intention for participating in this ceremony? *

By clicking the submit button on the bottom you agree to the following terms :

1. I understand that shamanic work may include the use of traditional healing plants. I agree that I always have a choice whether or not to participate, and I agree to take full responsibility for the choices I make involving this work, both during and after the event. To the best of my knowledge, I am in good physical condition and I am not aware of any physical, physiological, or psychological infirmity which would place me at risk to participate in any way within the ceremony activities.

2. I understand that while basic COVID 19 precautions will be taken during the ceremony I take full responsibility for my own health at all times. I agree that if I do experience any relevant flu like or viral symptoms or have any related health risk concerns, I will inform the facilitators immediately.

3. I take full responsibility for my own belongings and safe transportation to and from this event. I agree that while I have the space to authentically express myself I agree to keep to the agreements and hold the container set by the facilitators.

4. I understand that the facilitators reserve the right to deny my participation if they deem that it would be unsafe for me, or others, or for any other important reason. I agree to listen and follow all the instructions given by the facilitators.

5. I take full responsibility for any damage that I may cause to any facility that is used for the event.

6. I understand that the facilitators reserve the right to cancel the event for any reason and that I will be fully reimbursed or given the opportunity to rebook for a later date.

7. I hereby RELEASE, WAIVE, DISCHARGE AND COMMIT NOT TO SUE the facilitator, organizers and/or participants for any and all liabilities, claims, demands arising from or related to the event. I agree to participate with the purest intention of heart, promoting the health and well-being of all participants.

7. In submitting this form I acknowledge and represent that I have read and understand the above and sign voluntarily; I excuse this release for full, adequate and complete release of liability.

Full Name *

Date: *

Submit

TIGER HYMNSacred Medicine Ceremony PARTICIPATION Form

Email

TIGER HYMN
Sacred Medicine Ceremony PARTICIPATION Form