A California Nonprofit Mutual Benefit Corporation MEMBERSHIP RULES AND GUIDELINES
1. All members must be 18 years of age or older and possess a valid state issued ID.
2. All members must have a valid physician’s recommendation on file with the Collective at all times and agree that recommendations must be fully verified by an authorized agent of the Collective before any medicine may be provided.
3. All members agree to be respectful of the Collective’s neighbors and adhere to the Collective’s good neighbor guidelines and practices, including, but not limited to, not loitering, littering, using cell phones in an indiscreet manner or playing any loud music in and around the building and parking areas.
4. All members agree to arrive at the Collective’s premises alone, without any friends, family or children waiting in the car, unless a member is disabled and needs to be driven to the premises by another person.
5. All members agree to keep packages with medicine sealed until arriving at their final destination and agree not to bring any backpacks or other bags to the dispensary area. Members acknowledge having been advised that it is a good safety practice to lock any medication in the trunk upon leaving the premises.
6. All members agree not to use or consume any medication in or around the premises or their cars. Members acknowledge being advised that using marijuana might negatively affect their ability to drive a motor vehicle.
7. Members may not exchange money, share money or split payments for obtaining medication or any other purpose at any time while on the premises.
8. All members agree treat the Collective’s staff, management and other members with dignity and respect and understand the Collective’s staff and management reserve the right to refuse service to anyone at any time. Members understand that no acts of violence or threats of violence will be tolerated.
9. All members agree that no smoking, alcohol, illicit drugs or weapons are allowed on the premises at any time.
10. In the event of an emergency, all members must follow the instructions of the Collective’s management and staff.
11. All members understand and agree that maintaining safety, membership rules and adherence to the law are their collective responsibility. I hereby affirm that I have read, understand and agree to the terms of the foregoing rules.
MEMBER TERMS AND CONDITIONS
As an express conditions to (a) becoming a member of FLOWER POWERED (“Collective”), (b) entering the Collective's facility, and/or (c) obtaining medical cannabis, or any other product, herb, food, oil, or concentrate (collectively, “Cannabis Products”) from the Collective, the undersigned for himself/herself, his/her heirs, agents, representatives, and assigns, hereby irrevocably and forever releases and discharges, waives, relinquishes, quitclaims, settles and forgives all rights, interests, claims, demands, causes of action or chooses in action of whatsoever kind or nature, whether absolute, contingent, known, unknown, suspected or otherwise, and whether now existing or arising in the future, which they may now or hereafter have against the Collective, its members, officers, employees, agents, representatives, assigns, landlords, operators, managers, attorneys, growers, providers, wholesalers, and other members arising from or in any way related to:
1. The undersigned's use of any Cannabis Products obtained from the Collective;
2. The strength, potency, purity, toxicity, appropriateness for your condition of any Cannabis Products obtained from the Collective;
3. The undersigned's storage or handling of Cannabis Products obtained from the Collective. It is the intention of the undersigned that these Terms and Conditions shall be given full force and effect in accordance With each and all of the terms and provisions hereof, with respect to all claims, demands and causes of action which are subject to the provisions of paragraph and subparagraphs above, including, without limitation, all unknown or unsuspected claims, demands and causes of action, if any, and, in this regard, and without limiting the generality of any other term or provision hereof, the undersigned on behalf of his/her heirs, agents, representatives, and assign, does hereby expressly and irrevocably waive the provisions of California Civil Code Section 1542, and all of the rights and benefits conferred thereby, which provides as follows: “A general release does not extend to claims which the creditor does not know or suspect to exist in his favor at the time of executing the release, which if known must have materially affected his settlement with the debtor.” AS EXPRESS CONDITIONS TO (A) BECOMING A MEMBER OF THE COLLECTIVE , (B) ENTERING THE COLLECTIVE'S FACILITY, AND/OR (C) OBTAINING CANNABIS PRODUCTS FROM THE COLLECTIVE, THE UNDERSIGNED FOR HIMSELF/HERSELF, HIS/HER HEIRS, AGENTS, REPRESENTATIVES, AND ASSIGNS, HEREBY IRREVOCABLY AND FOREVER WAIVES AND DISCLAIM THE WARRANTY OF MERCHANTABILITY AND THE WARRANTY OF FITNESS FOR A PARTICULAR PURPOSE. KEEP MEDICINE FAR, FAR AWAY FROM CHILDREN OR ANYONE ELSE, UNDER LOCK AND KEY. ANY DEVIATION FROM THIS RULE IS DONE AT THE SOLE RISK AND RESPONSIBILITY OF THE PATIENT. Any Cannabis Products obtained at the Collective’s facility may be inspected prior to leaving the facility, however since medical purity so requires, all transactions are final. The Cannabis Products are offered solely on an AS IS basis with no warranty whatsoever.
I am either the Patient named above or the Patient’s legally authorized representative. This release authority applies to any information governed by the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), 42 U.S.C. § 1320(d) and 45 C.F.R. § 160-164, and/or information governed by the California Confidentiality of Medical Information Act (“CMIA”) Cal. Civ. Code § 56-56.37. Specifically, this release authority complies with the valid authorization requirements of 45 C.F.R. § 164.508(c). Pursuant to HIPAA and/or CMIA, I authorize and direct any physician, healthcare professional, dentist, health plan, hospital, clinic, laboratory, pharmacy, or other covered health care provider, any insurance company, and the Medical Information Bureau, Inc., or other health care clearinghouse that has provided treatment or services to me or that has paid for or is seeking payment from me for such services, to give, disclose, and release, without restriction, all of my individually identifiable health information and medical records regarding any past, present, or future medical or mental health condition, to include all information relating to the diagnosis and treatment of sexually transmitted diseases, mental illness, and drug or alcohol abuse to FLOWER POWERED, a nonprofit mutual benefit corporation. The purposes of the usage and disclosure shall include determinations regarding my qualification to use medical marijuana and monitoring my health care to protect my legal rights where I reside. I understand that, with certain exceptions, I have the right to revoke this Authorization at any time. If I want to revoke this Authorization, I must do so in writing. The procedure for how I may revoke this Authorization, as well as the exceptions to my right to revoke will be performed in accordance with applicable federal law and any applicable policy of my health care provider. I understand that I may refuse to sign this Authorization. I also understand that my health care provider cannot deny or refuse to provide treatment, payment, and enrollment in a health plan, or eligibility of benefits if I refuse to sign this Authorization. I understand that, once information is disclosed pursuant to this Authorization, it is possible that it will no longer be protected by applicable federal medical privacy law and could be re-disclosed by the person or agency that receives it; however, I do not authorize such secondary disclosure. The authority given to the persons or parties named above shall supersede any agreement that I may have made with my health care providers to restrict access to or disclosure of my individually identifiable health information. The authority given has no expiration date and shall expire only in the event that I revoke the authority in writing and deliver it to my health care provider.
COLLECTIVE MEMBERSHIP APPLICATION AND AGREEMENT
A California Nonprofit Mutual Benefit Corporation
I hereby state that as a qualified patient or a primary caregiver who has received a valid physician’s recommendation for the use of medical marijuana in accordance with the California Health and Safety Code § 11362.5 (“Proposition 215” or “Compassionate Use Act of 1996”) and Article 2.5, commencing with Section 11362.7, to Chapter 6 of Division 10 of the California Health and Safety Code (“SB 420”), wish to voluntarily join and become a member of FLOWER POWERED (the “Collective”) and agree to follow the terms and conditions as set forth in this agreement.
1. I hereby declare under the penalty of perjury under the laws of the State of California that a medical doctor recommended or approved my use of medical marijuana for an illness for which cannabis provides relief in accordance with the Compassionate Use Act of 1996 and SB 420.
2. As a member, I hereby appoint and designate the Collective and their representatives, as any true and lawful agents for the limited purpose of assisting me in obtaining my legally prescribed medical marijuana. I understand that this means that the Collective will be required to possess, purchase, cultivate, transport and/or distribute medical marijuana exclusively for member qualified patients or primary caregivers. Therefore, I grant the Collective’s management and other fellow members the limited authority to engage in the afore-mentioned tasks. I further agree and authorize the Collective and its members to use information relating to my status as a qualified patient as use of such information is reasonably necessary for providing my medical marijuana for my medical benefit as a qualified patient.
3. I authorize the Collective to create and/or assign agency rights in its own name for the purpose of growing marijuana for my personal medical reasons as well as for the medical benefit of other members of the Collective.
4. As a member, I understand that the Collective has other members who have joined and agreed to uphold the Collective’s rules and spirit by, among other things, signing a similar membership agreement. I hereby authorize the Collective to possess the medical marijuana as described under this agreement jointly with other members of the Collective under similar agreements. I agree that the medical marijuana possessed by the Collective is at any time the collective property of every patient who has joined the Collective, subject to the Collective’s rules and guidelines established by and for the Collective for handling medical marijuana for the benefit of member patients.
5. I agree to pay to the Collective all personal out-of-pocket expenses and reasonable compensation for services related to providing medical marijuana to me and other member patients.
6. I hereby verify that I am a resident of California and my personal medical marijuana will not be taken out of the State of California. I further verify and agree that medical marijuana shall not be shared, sold, bartered, traded, exchanged or delivered by any means to any other person for medical or other reasons. I understand that diversion of medical marijuana for non-medical purposes and/or to other individuals shall be grounds for the immediate termination of my membership. I also agree to request amounts of medicine strictly for my medical personal use at reasonably necessary intervals.
7. I agree to possess my original, or true and correct copy, of my physician's recommendation, when I am on the property used by or belonging to the Collective. I understand that my failing to do so may result in the termination of membership and that verbal recommendations from physicians will not be accepted. I hereby agree to all future changes of the Collective’s policies as the laws relating to access to medical marijuana might change. I further agree to provide the Collective with all changes relating to my contact information as well as my status as a qualified patient.
8. I understand and agree that adherence to the rules of the Collective is the collective responsibility of all patient members, including myself. I agree that any violation of the terms of this Agreement or any other Collective member rules are grounds for the immediate termination of my membership.
9. I understand and agree that while medical cannabis has been authorized by both the people of the State of California and its legislature, and consistently upheld by all California courts, the Federal Government persists in enforcing portions of the Controlled Substances Act, which makes the possession and use of medical cannabis a federal crime. I hereby certified that I have been advised by an authorized agent of the Collective that possession and use of marijuana for medical purposes might be grounds for prosecution under federal law.
10. I have read over this entire Collective Membership Application and Agreement and certify that an authorized agent of the Collective has personally gone over and explained fully to me each paragraph of this agreement and that I have been provided a copy of this agreement.
11. By joining FLOWER POWERED, all patients hereby agree to indemnity and hold harmless FLOWER POWERED from all alleged wrongdoing which may be the fruit of undercover investigations conducted by the patient during their membership with FLOWER POWERED. Any undercover officers, narcotics investigators with or without identification who join the collective and obtain information about the collectives activities hereby acknowledge to relinquish all information and agree that said information may not be used in a court of law to support any testimonial evidence by the member/officer. All new patients hereby agree that they have no associations with any law enforcement agencies or entities, and hereby agree not to mislead FLOWER POWERED by failing to admit that the new member is an undercover officer. All officers and law enforcement agents who pose as an undercover officer or not, hereby agree that all criminal evidence discovered as a result of the officer being a member of FLOWER POWERED is irrelevant heresay and inadmissible evidence in either a civil or criminal court setting. For the purposes of this section, all undercover investigations means all evidence and witness information derived from the undercover officers posing as a new patient, including but not limited to any patients who may be informants, in witness protection programs, patients possessing fraudulent documents, licenses, or posing as sales reps or producers
12. I hereby appoint Marcy Spears as my proxy to attend the meeting of the members of the Collective on all dates and times, and to represent, vote, execute, consent, waive and otherwise act for the undersigned in the same manner and with the same effect as if the undersigned were personally present at said meeting. I hereby affirm that I have read, understand and agree to the terms of the FLOWER POWERED Agreement. Further, I declare under the penalty of perjury that the above is true and correct to the best of my knowledge.