C.A.M.P.T. CORPORATION Non-Profit Collective Membership Agreement
OUR COMPASSIONATE CARE SERVICES ARE ONLY IN ACCORDANCE WITH CALIFORNIA HEALTH AND SAFETY CODE Sec 11362.775 & CALIFORNIA ATTORNEY GENERAL GUIDELINES, 2008.
As a qualified patient protected by California Law, Health & Safety Code §11362.5 and §11362.7, et seq., and, in conjunction with California State Senate Bill 420 and California Attorney General Guidelines, you are required to read and agree to the following statements to become a member of C.A.M.P.T. Corporation.
Please understand that these stipulations are for your protection, as well as ours. Please carefully read the statements below and initial at the bottom of the page to confirm that you understand each statement and are in agreement with each statement.
I hereby declare under penalty of perjury under the laws of the state of California that I am above TWENTY ONE (21) years of age and that I have a medical condition(s) as attested to on my information form from my medical doctor. A medical doctor recommended and/or approved my use of medical marijuana pursuant to Proposition 215. I have been diagnosed for an illness for which cannabis provides me with relief. I understand that I am allowed to enter into a contract with other medical marijuana patients in order to collectively cultivate my medical marijuana pursuant to California H and §11362.775. I understand under California Attorney General Guidelines, medical marijuana patients can create and/or become members of medical marijuana collective such as C.A.M.P.T. Corporation in order to obtain the services of safe and affordable access to cannabis. As a member, I hereby agree to appoint and grant C.A.M.P.T. Corporation, and their board members/officers and/or managers and employees, as my true and lawful agents for the limited purpose of assisting me in obtaining my legally recommended cannabis. I understand that C.A.M.P.T. Corporation will be required to; contract the cultivation, possession, extraction and transportation of my cannabis. I further authorize C.A.M.P.T. Corporation to share their status of my doctor recommendation in order to enter into contracts to obtain my cannabis. I understand that C.A.M.P.T. Corporation has other members with doctor’s recommendations to use cannabis. I hereby authorize C.A.M.P.T. Corporation to jointly possess, cultivate, transport and make available the medical cannabis with other collective members under similar membership agreements. I agree the medicinal cannabis possessed by this collective at any time is the collective property of every patient who is also a member of C.A.M.P.T. Corporation. I agree to provide C.A.M.P.T. Corporation with all changes in my contact information, diagnosis, or primary physician immediately. I also agree to pay all personal out-of-pocket expenses and reasonable compensation for C.A.M.P.T. Corporation’s collective services. I hereby declare and understand that my contributions to C.A.M.P.T. Corporation for their services, are used for the expenses and costs due to the services provided and/or allocation of cannabis and that any said transaction in no way constitutes a distribution of sale of cannabis. I hereby verify that my personal medical cannabis will not be available for any diversion out of the State of California and my medical cannabis will not be shared, sold, bartered, traded, exchanged or delivered in any other means to any other person who is not a member of this collective. I, , hereby understand that the C.A.M.P.T. Corporation has made no efforts in encouraging me to produce or use any substance for my medical condition. I understand that C.A.M.P.T. Corporation was organized to fill the necessity of providing medical cannabis services to medical marijuana patients and further understand that circumstances may require defense of authorization in a court of law and agree to participate in such defense to the extent necessary and practicable. I understand that the collective reserves the right to refuse services(s) to its members for any reason. I understand that medical cannabis, while being a well-known effective therapeutic agent, is still illegal under federal law. Even though the United States federal government officials have consistently denied that marijuana has any medical benefits, the federal government holds US Patent 6630507 titled “Cannabinoids as antioxidants and neuroprotectants” which is assigned to the United States of America, as represented by the Department of Health and Human Services, therefore, by signing this form, all members of C.A.M.P.T. Corporation are committing an act of collective Federal civil resistance. I authorize C.A.M.P.T. Corporation to acknowledge the fact of my membership, when needed, for the preservation of my medical rights under the Compassionate use Act of 1996.
DISCLAIMER-GENERAL RELEASE, INDEMNIFICATION AND HOLD HARMLESS CLAUSE
, being of lawful age and sound mind, do now release, acquit and forever discharge C.A.M.P.T. Corporation and member operators, board members, attorneys, consultants, employees and volunteers of C.A.M.P.T. Corporation from all actions, claims, demands, or damages accruing to me from any known or unknown injury, loss or damage sustained by/or to me.
I further agree to indemnify and hold harmless C.A.M.P.T. Corporation from any injuries or damages resulting from my use or misuse of medical cannabis obtained from C.A.M.P.T. Corporation non-profit membership collective.
This release shall remain in force and run concurrently with my membership in C.A.M.P.T. Corporation.
In witness where of, I have executed this release in California, I hereby affirm that I read, understand and agree to the terms of C.A.M.P.T. Corporation’s Membership Agreement.
Date: Print Name: Street Address: City, State, Zip: Email: Cell: California DL or ID#: Doctor’s Name: Doctor’s Phone: New Member Signature: Physicians Statement & Recommendation: Driver's License/Photo ID: By Registering & Clicking The Send Button You Are Agreeing To Our Collectives Terms & & Conditions Please fill the below code: