As a qualified patient protected by California Law, Health & Safety Code §11362.5 and §11362.7, et seq., and, in conjunction with California Health & Safety Code § 11362.775, you are required to read and agree to the following to become a member of Club Kindness, Inc. Please understand that these are for your protection, as well as ours. Please read the following statements and initial that you have read each where provided. Please sign the bottom of this form confirming that you have read each of the statements and understand them. Club Kindness (“Cannabis Club”), a NON-PROFIT Consumer Cooperative Corporation facilitates the association of qualified medical patients for the purpose of collectively cultivating medical cannabis for its members, pursuant to Health and Safety Code sections 11362.765 and 11362.775. The Cannabis Club is dedicated to providing our members with the highest level, quality service pursuant to the Compassionate Use Act and Medical Marijuana Program Act (Health & Safety Code § 11362.5, et seq.). This agreement contains member requirements and guidelines to ensure compliance with the Compassionate Use Act, Medical Marijuana Program Act and the Attorney General’s Guidelines for the Security and Non-Diversion of Marijuana Grown for Medical Use; to protect the safety and further the health and wellbeing of members; and to continue to create a member-run, community-based, alternative healing and wellness organization.
I am a qualified patient entitled to the protection of California Health and Safety Code section 11362.5, et seq., because my physician has recommended/approved my use of cannabis for medical purposes.
In order to acquire the medicine my physician recommends, and in accordance with Health and Safety Code § 11362.5, et seq., I hereby seek membership in the Cannabis Club and understand that in order to be a member of the Cannabis Club, and to maintain my membership in the Cannabis Club, I must agree to, and follow all terms and conditions set forth in this agreement
My physician has determined that I suffer from a serious medical condition for which medical cannabis provides relief and has provided a written recommendation that verifies this fact. As a condition of membership, I have provided a copy of such recommendation to the Cannabis Club, as well as a copy of my current California Drivers License or other recognized form of state issued identification. I understand that the Cannabis Club will keep a copy of these documents on file and will independently verify with my physician my medical recommendation that forms the basis of my right to be considered a qualified patient under California law.
I agree to provide the Cannabis Club with my current medical recommendation. I understand that the Cannabis Club will keep a copy of my recommendation on file, but may require that I produce it anytime I obtain my medical cannabis. I understand that any member whose medical recommendation is expired shall be excluded from membership until such time that their qualified status pursuant to the Compassionate Use Act can be verified.
I understand that as a member of the Cannabis Club, I must inform the club of the specific strain(s) of medical marijuana I need and to which I am entitled and, to that end, I agree to assist, if necessary, in any aspect of the cultivation process including, but not limited to, cutting clones, trimming, and/or reimbursing actual costs incurred. I also understand that I may be called upon to contribute finances, labor and/or resources to the Cannabis Club. Such contributions are necessary to REIMBURSE THE OVERHEAD and to cultivate my medical cannabis, as well as to conduct the day-to-day operations of the Cannabis Club for the benefit of its members.
I agree and understand that all medicine obtained is for medical use only and may not be diverted for non-medical use or for use by a non-member of the Cannabis Club. I understand that it is a violation of this agreement and of California law to sell or divert my medicine in any way and for any reason to any other person and a violation of this section will result in immediate revocation of my membership in the Cannabis Club. Also, to prevent diversion of marijuana to non-members, I understand that the Cannabis Club limits disbursement of medicine to no more than eight (8) ounces per month unless specifically authorized by management.
I agree to assign agency rights to the Cannabis Club for the limited purpose of obtaining legally cultivated medical cannabis and for purposes of growing medication for my benefit. I understand that the Collective is required to possess, transport, and cultivate medical cannabis on my and other members’ behalf, and limited authority is granted to the Cannabis Club for this purpose.
I understand that my medical cannabis recommendation may be disclosed pursuant to any required audits by any Government agency for purposes of verifying the Cannabis Club’s compliance with the Compassionate Use Act, the Medical Marijuana Program Act, the Attorney General Guidelines, or any local ordinance. I understand that the Collective may maintain records of my medical use in order to demonstrate compliance with the Compassionate Use Act, the Medical Marijuana Program Act, the Attorney General Guidelines, or any local ordinance, and, further, that the Cannabis Club will take all legal steps necessary to keep such records private and confidential, subject to the need of the Cannabis Club to use such records to defend itself and establish that the conduct of the Cannabis Club and its members did not violate the law.
As a member of the Cannabis Club, I recognize that there are risks inherent in the use of medical cannabis. All medical cannabis is obtained from members of the Cannabis Club at various locations not necessarily under the Cannabis Club’s direct supervision. While the Cannabis Club takes every reasonable precaution to assure the quality, purity and effectiveness of the medical cannabis, the Cannabis Club makes no warranties or representations as to the quality, purity and effectiveness of the medical cannabis. I understand that the Cannabis Club is not responsible for the effects and makes no representation or warranties, express or implied, with regard to the safety, effect or efficacy of the medical cannabis I may obtain from the Cannabis Club when used by itself or with other medicine.
I hereby release, waive and discharge the Cannabis Club, including its officers, agents, employees, managers, independent contractors, parent organizations, subsidiaries, affiliates and other personnel (“Releasees”) from, and agree and covenant not to sue Releasees for, any claim, liability, or demand of any kind or on account of any personal injury, temporary or permanent disability, death, property damage, or other damages, whether caused by the negligence of Releasees or otherwise, resulting from or in any way associated with my presence on the premises Club’s facilities, amenities, or services.
As a member of the Cannabis Club, I agree to follow the Bylaws, Rules and Policies of the Club and I acknowledge I have been provided an opportunity to review the Club’s Bylaws, Rules and Policies.
I declare under penalty of perjury that the information provided on this membership agreement is true and correct. I further declare under penalty of perjury that I am a medical cannabis patient and will not divert my medicine for non-medical use or for use by a non-member. I further declare under penalty of perjury that I am not a member of law enforcement and will not divert any medicine for the purpose of any criminal investigations. I have read and understand the above requirements and agree to follow these guidelines. I understand that smokable marijuana contains a chemical known to the State of California to cause cancer. I acknowledge that I have been offered the ability to review a copy of the Articles of Incorporation, Bylaws, and Membership Rules and Policies. Additionally, I hereby authorize the release of my medical information concerning my diagnosis, condition or prognosis to the Collective and its authorized representatives for purposes of verifying the validity of my medical recommendation and the valid operation of the Cannabis Club pursuant to the Compassionate Use Act and Medical Marijuana Program Act.