I will not sell, furnish, or in any way distribute cannabis to nonmembers; use the cannabis for any purpose other than to treat my medical condition; and at all times, maintain a valid verifiable Prop. 215 Physician’s Recommendation. If it expires or is revoked or rescinded for any reason, I will immediately notify the Collective and will not, under any circumstances, attempt to obtain cannabis from the Collective until it is renewed or a new Recommendation is obtained.
I agree that as a condition of my membership in the TOP SHELF MEDICINAL ( “Collective”), I will comply with all terms and conditions in this Membership Application and Agreement.
As a qualified medical marijuana patient under the Compassionate Use Act, and the Medical Marijuana Program Act, I intend to associate with the members of the medical marijuana collective, in part to collectively cultivate marijuana for medical purposes pursuant to the Medical Marijuana Program Act, which includes in part, California Health and Safety Code § 11362.775 and Section 1(b)(3) of the uncodified portion of the Medical Marijuana Program Act, which was enacted by the People of the State of California, in part, in order to promote
uniform a and consistent application of the Compassionate Use Act among the counties within the state, and to enhance the access of patients and caregivers to medical marijuana through collective, cooperative cultivation projects.
As a member of the medical marijuana collective, I understand and agree that each and every member of this collective will contribute labor, funds, supplies, services, and/or materials towards the cultivation and/or procurement of marijuana for medical purposes; and by executing this agreement, I agree that a requirement of my membership is that I be available for such tasks when needed; or in the alternative, I may be required to reimburse the members for their operating costs and expenses.
As a qualified medical marijuana patient and member of the collective pursuant to California Health and Safety Code § 11362.775, I specifically authorize the Collective, through its Board of Directors, to cultivate, transport and otherwise prepare Marijuana for my medical use and benefit.
In order to become a member of the Collective, I must provide to the Collective a Valid California Identification Card or Driver’s License; and either one of the following items of proof of qualified patient status: A State of California Medical Marijuana Program Identification Card; or a valid and verifiable California Physician’s Recommendation for the use of Medical Cannabis. By Signing below I certify that a true and correct copy of my current written physician’s recommendation and/or a State of California MMP identification card is attached.
I understand that the Collective has no members within the meaning of Section 5056 of the California Corporations Code and that the ByLaws do not confer any voting rights on any member for any purpose. As such, I agree and acknowledge that I shall not be considered as a voting member of the Collective and shall have no right to vote as a member of the Collective for any purpose as such. If, for any purpose, it may be determined that I may have the right to vote on any matter affecting the Collective, then I do hereby assign and transfer any such voting rights and coupled with an interest to the Directors of the Collective.
By signing this Application and Agreement, I acknowledge that I have read this entire Membership Application Agreement, and I agree to abide by the Rules as stated herein. I understand that my membership may be terminated at any time by the Collective management if it is determined that I have violated any of the rules or other conditions of this Membership Application Agreement.
I hereby affirm that I read, understand and agree to the terms and conditions of this membership agreement without reservation.
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 statements to become a member of SWEETWOOD PATIENTS’ COOPERATIVE, INC. SWEETWOOD PATIENTS’ COOPERATIVE, INC. (“Cooperative”), 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. 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.
I hereby declare and agree as follows:
Article 1. 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.
Article 2. 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 Cooperative, as well as a copy of my current California Drivers License or other recognized form of state issued identification. I understand that the Cooperative 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.
Article 3. 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 Cooperative and understand that in order to be a member of the Cooperative, and to maintain my membership in the Cooperative, I must agree to, and follow all terms and conditions set forth in this agreement.
Article 4. I agree to provide the Cooperative with my current medical recommendation. I understand that I will provide a copy of my valid medical recommendation each and every time I purchase medicine from the Cooperative. 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.
Article 5. I understand that as a member of the Cooperative, I will inform the Cooperative of the specific strain(s) of medical marijuana I need and 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 Cooperative. Such contributions are necessary to REIMBURSE THE OVERHEAD and cultivate the medical cannabis to which I am entitled and need, as well as to conduct the day-to-day operations of the Cooperative for the mutual benefit of its members.
Article 6. I have been informed and understand that there will be an ANNUAL MEETING OF ALL MEMBERS of the Cooperative for purposes of voting as to the operation of the Cooperative. I understand that my attendance is very important in order to help make decisions necessary to the day-to-day operations of the Cooperative for the benefit of all members
Article 7. I have been informed and understand that the Cooperative will make available to me upon reasonable request records verifying the reimbursement necessary to compensate patient-members’ out-of-pocket expenses, time spent, and any and all operation and overhead expenses incurred in the course of cultivating and otherwise making available medical cannabis on behalf of the Cooperative.
Article 8. I agree to assign agency rights to the Cooperative for the limited purpose of obtaining legally cultivated medical cannabis and for purposes of growing medication for my benefit. I understand that the Cooperative is required to possess, transport, and cultivate medical cannabis on my and other members’ behalf, and limited authority is granted to the Cooperative for this purpose.
Article 9. 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 Cooperative. 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 Cooperative. Also, to prevent diversion of marijuana to non-members, I understand that the Cooperative limits disbursement of medicine to no more than eight (8) ounces per month unless specifically authorized by management.
Article 10. I understand that my medical cannabis recommendation may be disclosed pursuant to any required audits by any Government agency for purposes of verifying the Cooperative’s compliance with the Compassionate Use Act, the Medical Marijuana Program Act, the Attorney General Guidelines, or any local ordinance. I understand that the Cooperative 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 Cooperative will take all legal steps necessary to keep such records private and confidential, subject to the need of the Cooperative to use such records to defend itself and establish that the conduct of the Cooperative and its members did not violate the law.
Article 11. As a member of the Cooperative, I recognize that there are risks inherent in the use of medical cannabis. All medical cannabis is obtained from members of the Cooperative at various locations not necessarily under the Cooperative’s direct supervision. While the Cooperative takes every reasonable precaution to assure the quality, purity and effectiveness of the medical cannabis, the Cooperative makes no warranties or representations as to the quality, purity and effectiveness of the medical cannabis. I understand that the Cooperative 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 Cooperative when used by itself or with other medicine.
Article 12. I hereby release, waive and discharge the Cooperative, 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 Cooperative’s facilities, amenities, or services.
I declare under penalty of perjury that the information provided on this membership agreement is true and correct. I have read and understand the above requirements and the “Membership Rules & Policies” provided herewith and agree to follow these Rules and guidelines. 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. Additionally, I hereby authorize the release of my medical information concerning my diagnosis, condition or prognosis to the Cooperative and its authorized representatives for purposes of verifying the validity of my medical recommendation and the valid operation of the Cooperative pursuant to the Compassionate Use Act and Medical Marijuana Program Act.
I hereby agree that as a condition of my membership in the DCSM, I will comply with all terms and conditions in this Membership Application and Agreement. By becoming a member of the DCSM, I specifically authorize the DCSM, through its members, to cultivate, transport and
otherwise prepare Marijuana for my medical use and benefit, for which I may be required to reimburse the members for their operating costs and expenses as determined by the Collective management.
In order to become a member of the DCSM, I must provide to the Collective a record of the following:
The following are the Collective’s Rules which must be abided by at all times:
a) I will not use the Collective’s cannabis for other than medical purposes;
b) I will not to sell, furnish, or in any way distribute cannabis to non-members;
c) If my Recommendation expires or is revoked or rescinded for any reason I will immediately
notify the Collective and will not under any circumstances attempt to obtain cannabis from
the Collective without a valid and authentic Physician’s Recommendation.
In consideration of your membership the Collective agrees to assume the following responsibilities:
a) To safely and securely maintain the membership records and to protect member’s medical privacy by not disclosing, publishing, or furnishing medical or membership information to any person or organization whatsoever, including law enforcement, unless the member specifically requests the Collective to do so, or agrees to the disclosure of his or her medical and or membership records prior to the information being disclosed;
b) To track the expiration and renewal of each member’s medical cannabis recommendation and/or identification cards;
c) To enforce the conditions of membership by excluding members whose identification card or
physician recommendation are invalid, have expired, or who are caught diverting marijuana for
non-medical use, or participating in any type of behavior that the Collective does not feel is
consistent with the Collective’s mission;
d) To operate at all times as a Non-profit Collective, to maintain a valid Seller’s Permit from the
State of California, and to pay Sales Tax on all transactions as required under the laws of the State.
By signing this Application and Agreement, I acknowledge that I have read this entire Membership Application Agreement and agree to abide by the Rules as stated herein. I understand that my membership may be terminated at any time by the Collective management if it is determined that I have violated any of the rules or other conditions of this Membership Application Agreement, if I am no longer a qualified patient or caregiver under California law, or if my behavior is inconsistent with the values and/or interests of the patients that apprise the DCSM.
I hereby declare under penalty of perjury under the laws of the State of California that:
(1) I am a California resident who is at least 18 years of age;
(2) I have a valid California issued Driver’s License or Identification Card; and
(3) I have a valid written approval or recommendation by a licensed California physician to use medical cannabis for my documented medical condition(s).
As a qualified medical cannabis patient protected by California law, you are required to read and to agree with the following statements to become an Member of Torrey Holistics Cooperative INC., a California nonprofit Consumer Cooperative Corporation (hereinafter, the “Cooperative”). After reading the following statements, please sign and date in the space provided below to certify that you have read, understood, and that you agree with each statement, and that you agree to abide by the terms of this Agreement, the Bylaws of the Cooperative, and all policies and procedures of the Cooperative.
I understand that the Cooperative consists of qualified medical cannabis patients who are residents of the State of California and who have voluntarily joined together to share resources in connection with the cultivation, transportation and distribution of medical cannabis for each other’s respective medical condition(s). As a qualified patient, I choose to become an Member of the Cooperative.
I hereby appoint and designate the Cooperative and its representatives as my true and lawful agents for the limited purpose of assisting me in my medical cannabis needs. I understand this means that the Cooperative, by and through its members, may cultivate, purchase, possess, transport and distribute medical cannabis to me, with me, or from me (as applicable) and I grant them the authority to do so.
I understand that the Cooperative intends to operate in full compliance with all applicable California laws, and I agree to not take any actions which may cause violations of such laws or otherwise jeopardize the ability of the Cooperative to operate.
I understand that all application fees (if applicable) and membership fees (if applicable) paid to the Cooperative will be used by the Cooperative to reimburse for actual expenses and reasonable costs associated with the operation of the Cooperative. In addition, I understand that in order to remain a viable nonprofit entity the Cooperative must charge its members for medical cannabis, and that the Cooperative will only charge an amount that allows for it to cover its actual expenses and reasonable costs associated with the operation of the Cooperative, including all overhead expenses, a reasonable salary for any one or more of its officers as determined by the Board of Directors of the Cooperative, and an appropriate amount of reserve funds to be used for improvements to the Cooperative’s operations, emergencies, repairs, or as otherwise determined by the Board of Directors of the Cooperative.
I agree to provide my valid California physician’s recommendation for medical cannabis use and my valid California Driver’s License or California Identification Card to a representative of the Cooperative each and every time I obtain medical cannabis from the Cooperative, provide medical cannabis to the Cooperative, or otherwise engage in any dealings with the Cooperative or its members pertaining to cannabis. In addition, I authorize the Cooperative to make photocopies of such documents and to keep such photocopies with the Cooperative’s business records, which may be digital, physical, or both. I acknowledge that the Cooperative will attempt to keep such personal information confidential, but may be required by law, court order, or otherwise to reveal any or all of such information to third parties, including local, state, and/or federal authorities.
I agree that only I or my designated caregiver (who must also be a member of the Cooperative) will interact with the Cooperative in regards to obtaining medical cannabis from the Cooperative, providing medical cannabis to the Cooperative, or otherwise engaging in any dealings with the Cooperative or its members pertaining to cannabis.
I agree to not share, sell or distribute any medical cannabis I obtain through the Cooperative with any person or entity who is not a member of the Cooperative.
I understand that the Cooperative requires that I provide my current and valid e-mail address for purposes of the Cooperative providing me with notices of meetings, events, and other information, and I agree to the terms of the Consent to Electronic Transmission document which I have signed and included herewith.
I agree that no photos, video recordings, weapons, illegal drugs or dangerous activities are permitted at any location owned, leased or controlled by the Cooperative.
I hereby authorize my California physician who recommended that I use medical cannabis to release my personal healthcare information concerning my medical diagnosis, condition, and medical cannabis recommendation to the Cooperative. I acknowledge that the Cooperative will attempt to keep such personal healthcare information confidential, but may be required by law, court order, or otherwise to reveal any or all of such information to third parties, including local, state, and/or federal authorities.
I agree to promptly contact the Cooperative if there are any changes to my contact information, primary caregiver (if applicable), or the status of my medical cannabis recommendation.
I hereby join and consent to the benefits provided by membership in Emerald City Collective, a collective operated by a nonprofit corporation (“ECC”). I am informed that ECC is a nonprofit collective organized as a means for facilitating or coordinating transactions between members. I understand that ECC has made no efforts encouraging me to produce or use any substances for any medical condition. I have been informed by ECC that I should continue to seek professional medical advice regarding my use of any cannabis product. I understand that ECC reserves the right to refuse service(s) to members. I understand that any person caught violating ECC’s Rules or Membership Agreement may be excluded from membership. I am informed that membership is open to patients whose physicians’ recommendations or approvals for cannabis, or whose medical cannabis identification cards, have not expired, and to designated primary caregivers of such patients. I agree not to use cannabis for other than medical purposes. I understand that any member caught diverting cannabis for non-medical use may be excluded from membership. I affirm that I am above 18 years of age or have the consent of my parent/guardian, and that the information stated on my Information Form is truthful and accurate. If I am on parole or probation or released on bail, I certify that no condition of such parole, probation, or bail prohibits my use of medical cannabis. I understand that my contributions to ECC through products I may acquire from the collective are used to ensure continued operation of ECC, and that such transactions are exchanges to cover overhead costs and operating expenses, and in no way constitute commercial promotion. I understand that medical cannabis, while being a well-known effective therapeutic agent, is still considered illegal by the federal government. Therefore, by signing this form, all members of ECC are committing an act of collective federal civil resistance. I acknowledge that Emerald City reserves the right to amend or update this agreement periodically and will provide proper notice to Member in the event of any change in terms. Any amendment initiated by the Member must be agreed to in a signed writing approved by a director or manager of the collective. I declare under penalty of perjury under the laws of the State of California and the United States America that all the information stated herein is true and correct, and that I have signed this declaration on date indicated below. I authorize my physician to verify to the Emerald City Collective his or her recommendation for my use of medical cannabis.
Welcome to our Collective.
In order that we may best serve you and the community, below are the rules and policies for continued membership: A physician recommendation or approval for use of medical cannabis must be kept current at all times. Only valid Collective Patient/Members may enter the Collective Facility. The Patient/Member is responsible for knowing when their recommendation or approval expires and submitting the updated documentation prior to said expiration. All recommendations and approvals, both initial and renewals, will be verified by the Collective. Submission of false identification or intentionally misleading forms, documents, and/or records shall be grounds for expulsion from the Collective and cancellation of membership. Medical cannabis obtained through the Collective is for the personal medical use of the Patient/Member only, and may not be redistributed to any other person for any purpose. Such redistribution shall be grounds for expulsion from the Collective and cancellation of membership. The Member/Patient hereby authorizes the Collective and the use of their physician recommendation or approval to support the Collective’s cultivation of medical cannabis for and/on behalf of our members/community. All Collective Patients/Members shall be respectful and cognizant of the other Collective Members, Employees, and Neighbors at all times. There is no offensive conduct or language allowed in the Collective Facility. Redistribution or re-sale of medicine, loitering, loud noise, and smoking medicine in the vicinity of the Collective Facility is strictly prohibited. Violation of these rules shall be grounds for expulsion from the Collective and cancellation of membership. The Patient/Member agrees to reimburse the Collective for the actual cost of cultivation or acquisition of medical cannabis, services, expenses and maintenance of the Collective. Services of the Collective may include, but are not limited to, massage, counseling, acupuncture, and food. Maintenance and expenses of the Collective may include, but are not limited to, rent, salaries, insurance, utilities, and other expenses incurred by the Collective as a direct result of providing for the Collective Member’s medical needs. Any funds remaining after all expenses incurred by the Collective are distributed, maybe
provided to the Collective Members in the form of services, medicine, and/or disbursement in a manner that is for the benefit of the Collective Members including, but not limited to charitable donations. Decisions regarding resource distribution shall be determined by management. I hereby agree to the Collectives above stated rules and policies.
Read and agree to the following before joining The Guild and associating with your fellow members.
The Guild is a not-for-profit, mutual benefit corporation. The Guild is composed entirely of legally qualified medical cannabis patients and caregivers who have chosen to associate to enhance the development of physical, mental, and emotional fitness of its members, find solutions for, and share knowledge of the health problems of its members, and to facilitate and/or coordinate the cultivation and distribution among the members of herbal remedies including cannabis for medical purposes as lawfully permitted under the laws of the State of California, including but not limited to the cultivation of medical cannabis (CA H&S Cd. 11362.775). Read the Bylaws.
In order to be member and maintain membership, you must qualify as a member, and maintain that qualification. Minimum qualification requires that: a) That at all times you are an adult California resident, 21 years of age or older, qualified patient or primary caregiver; b) You abide by the Bylaws and Rules and Regulations of The Guild and the laws of the State of California and the City of San Jose as it pertains to medical cannabis; c) You timely pay all contributions, dues, assessments and/or fees; d) You refrain from use Medical Marijuana for other than medicinal purposes and from any other unlawful purpose under the laws of the State of California, and refrain from distribution of medical cannabis received from The Guild to non-members, e) You not suffer conviction of any drug related felony within the last 5 years, including violation of Section 11351, 11351.5, 11352, 11355, 11359, 11360, 11378, 11378.5, 11379, 11379.5, 11379.6, 11380, 11382, or 11383 of the Health and Safety Code, or Section 182 of the Penal Code, or a felony violation of Health and Safety Code] Section 11366.8, insofar as the offense involves manufacture, sale, possession for sale, offer for sale, or offer to manufacture, or conspiracy to commit at least one of those offenses.
Acceptance of your membership and access to the premises, product and services of The Guild is expressly conditioned upon truthful information having been provided in this application. You agree to immediately report to The Guild any circumstances affecting your qualification. You are associated with other The Guild members and to faithfully follow and obey all The Guild Bylaws, Rules and Regulations as outlined in the patient orientation package, and the laws of the State of California as it pertains to medical cannabis. As a member you are agreeing that the Collective may facilitate and/or coordinate the cultivation and distribution of medical cannabis jointly and collectively for the members, including by possession of medical cannabis on my behalf. You agree to accept notice of membership matters by electronic transmission. The e-mail address provided on this form as the address on record of the member, until changed in writing by the member. You consent to inspection and copying of records of the Collective as specified in Subsection 6.88.330B, of Title 6 of the San Jose Municipal Code.
You acknowledge and understand that you are participating in membership activities, using the services and facilities of The Guild, as well as products received, used or possessed (including cannabis) at your own risk. The Guild and that the members, officers, employees, agents, contractors and affiliates of the Collective shall not be liable–and you hereby expressly waive any claim of liability–for personal/bodily injury or damages–which occur to you, for any and all loss or injury to person or property. This waiver is intended to be a complete release of any responsibility for personal injuries and/or property loss/damage you sustain arising from membership activities, arise from use of services or facilities, and/or arise from possession or use of products (including cannabis) obtained as a member, and/or occur while on The Guild Premises of the Collective, whether using services or products or not. IN CONSIDERATION OF BEING PERMITTED TO PARTICIPATE AS A MEMBER AND/OR IN ANY MEMBER ACTIVITY, AND/OR USE OF ANY The Guild FACILITIES, AND/OR USE OR POSSESSION OF ANY PRODUCT RECEIVED AS A MEMBER (INCLUDING CANNABIS), IN CONNECTION WITH THIS MEMBERSHIP OR MEMBERSHIP ACTIVITY OR USE OR POSSESSION, YOU AGREE TO THE FOLLOWING: 1. YOU HEREBY RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE The Guild, ITS EMPLOYEES, OFFICERS AND AGENTS (hereinafter referred to as ‘releasees’) from all liability to you, your personal representatives, assigns, heirs and next of kin for any loss, damage, or claim therefore on account of injury to your person or property, whether caused by any negligent act or omission of the releasees or otherwise while you are participating as a member and/or membership activity and/or using any The Guild facilities in connection with the activity and/or using or possessing any product received as a member of The Guild (including cannabis). 2. YOU HEREBY AGREE TO INDEMNIFY AND HOLD HARMLESS the releasees from all liability, claims, demands, causes of action, charges, expenses, and attorney fees resulting from your involvement in this membership or membership activity or by use or possession of any product received as a member of The Guild (including cannabis) whether caused by any negligent act or omission of the releasees or otherwise. 3. YOU HEREBY ASSUME FULL RESPONSIBILITY FOR AND RISK OF BODILY INJURY, DEATH OR PROPERTY DAMAGE while upon The Guild property or participating in membership activity or by use or possession of any product received as a member of The Guild (including cannabis) whether caused by any negligent act or omission of releasees or otherwise. You expressly agree that the foregoing release and waiver, indemnity agreement and assumption of risk are intended to be as broad and inclusive as permitted by California law. You acknowledge that you are not relying upon any representation by The Guild or any agent of The Guild as to your suitability to engage in membership activities and/or the suitability or condition of any products received used, or possessed (including cannabis) by you. You expressly agree that you are relying exclusively upon your own judgment and opinions and/or those of your health care providers or other professionals as to you suitability to engage in membership activities and/or the use or possession of products (including cannabis) and/or condition of any products (including cannabis) received used, or possessed by you. You are strongly advised to consult with health care providers and professionals with appropriate qualifications as to your suitability to engage in membership activities or the suitability or condition of any products (including cannabis) received used, or possessed by you.