Participant Acknowledgment of Risk & Informed Consent

Church of the Living Monad — Sacramental Ceremony

1. The Nature of What You Are Undertaking

I understand that I am choosing to participate in a religious ceremony of the Church of the Living Monad involving the sacramental consumption of an entheogenic sacrament. I understand this is a sacred and serious undertaking, not a recreational or casual one, and that it may produce powerful physical, emotional, psychological, and spiritual effects.

I understand that the sacrament contains naturally occurring compounds, including MAO inhibitors and other psychoactive substances, that act profoundly on the body and mind.

2. Physical Risks

I understand and accept that participation carries real physical risks, which may include but are not limited to:

Common effects: intense nausea, vomiting (often part of the cleansing process), diarrhea, sweating, chills, shaking, dizziness, changes in heart rate and blood pressure, and physical exhaustion.
Dangerous interactions: the sacrament’s MAO-inhibiting properties can interact dangerously with certain foods, medications, and supplements, potentially causing a hypertensive crisis (a severe and dangerous rise in blood pressure) or serotonin syndrome (a potentially life-threatening reaction). I am responsible for full and honest disclosure of my diet, medications, and supplements, and for following all preparation instructions.
Cardiovascular events: the strain on the cardiovascular system may pose serious risk, particularly for those with underlying heart conditions.
Other serious outcomes: including but not limited to seizures, injury, and other adverse medical events.

3. Acknowledgment of the Risk of Death

I understand that, in rare cases, participation in ayahuasca ceremony has been associated with serious injury and death. I understand that while the Church takes significant precautions — including medical screening, physician supervision, and preparation requirements — these precautions reduce but cannot eliminate this risk. I accept that death is a possible outcome of participation, and I choose to participate with full awareness of this possibility.

4. Psychological Risks

I understand that the sacrament may bring forward intense and difficult psychological and emotional experiences, which may include:

Profound fear, anxiety, panic, or a sense of dying or dissolution.
Confronting suppressed memories, trauma, or emotions.
Confusion, disorientation, or a temporary loss of ordinary sense of reality.
In some individuals, the possibility of triggering or worsening underlying psychiatric conditions, including prolonged psychological distress or, rarely, psychosis.

I understand that difficult experiences during ceremony are sometimes part of the process, and that the effects may continue or re-emerge in the days and weeks afterward, making integration and support important.

5. My Responsibilities

I affirm that:

I have completed the screening questionnaire truthfully and completely.
I have disclosed all medications, supplements, and substances I use, and all relevant medical and psychiatric history.
I have followed, or will follow, the dieta and all preparation instructions provided to me.
I have not concealed any condition that could affect my safety.
I will not participate under the influence of alcohol or recreational drugs.
I will inform ceremony staff immediately if I feel physically unwell or in distress.
I understand that any medication changes must be made only with my prescriber’s guidance, never on my own.

6. Voluntary and Religious Participation

I affirm that:

I am participating of my own free will, as a sincere act of religious and spiritual practice.
No one has pressured or coerced me into participating.
I am an adult of sound mind, capable of making this decision for myself.
I may choose to decline or withdraw from participation at any time before the ceremony begins.

7. Medical Supervision — What It Does and Does Not Mean

I understand that the presence of medical screening and physician supervision is a safety measure intended to reduce risk. I understand that it does not guarantee my safety, does not eliminate the risks described above, and does not constitute a promise of any particular medical outcome. I understand the distinction between the Church’s ceremonial role and any individual’s professional medical role, and that participation is a religious act undertaken within the Church.

8. Confidentiality and Consent to Emergency Care

I consent to allow Church staff to seek emergency medical care on my behalf if, in their judgment, my safety requires it. I understand that I am responsible for the costs of any such care.

9. Legal Release and Assumption of Risk

OKLAHOMA ASSUMPTION OF RISK, RELEASE, WAIVER, AND INDEMNIFICATION AGREEMENT

Voluntary Participation and Assumption of Risk
I, the undersigned participant, acknowledge that my participation in the activities, programs, services, and events hosted, organized, or sponsored by [Name of Church] (the “Church”) is entirely voluntary. I explicitly recognize and understand that these activities may involve inherent and unanticipated risks, dangers, and hazards that could result in property damage, severe illness, physical injury, or death. Under Article XXIII, Section 6 of the Oklahoma Constitution, I recognize that the question of assumption of risk is a matter of fact. By executing this Agreement, I expressly, knowingly, and voluntarily elect to encounter and assume all known and unknown risks associated with my participation in any Church activities.
Clear and Unequivocal Release and Waiver of Liability
I, to the fullest extent permitted by Oklahoma law, forever release, waive, and covenant not to sue the Church, its staff, and volunteers (“Released Parties”) from all claims arising from ordinary negligence, including premises liability and supervision.
Limits of Waiver: Gross Negligence and Recklessness Excluded
This agreement does not release, waive, or exempt the Released Parties from liability resulting from gross negligence, willful injury, recklessness, or intentional torts.
Indemnification and Hold Harmless
I agree to indemnify and hold harmless the Released Parties from all third-party claims, costs, and attorney’s fees resulting from my actions or participation.
Relationship to the Church’s Posture Under the Religious Freedom Restoration Act (RFRA)
The Church’s activities are an extension of its religious exercise. The Church asserts its rights and protections under the Oklahoma Religious Freedom Act (ORFA) (51 O.S. § 251 et seq.) and the federal Religious Freedom Restoration Act (RFRA).
Governing Law, Jurisdictional Venue, and Court Costs
This Agreement is governed by Oklahoma law. Any legal action must be brought exclusively in the District Court of [Insert County Name] County, Oklahoma.
Severability Clause
If any portion of this Agreement is held invalid, the remaining provisions shall remain in full force and effect.
Acknowledgment of Opportunity for Independent Counsel and Medical Advice
I confirm I had the opportunity to consult with independent legal and medical counsel, and I sign this voluntarily.

Participant Acknowledgment & Signature

I have read this document in full, or had it read to me. I have had the opportunity to ask questions, and my questions have been answered to my satisfaction. I understand the risks described, including the risk of death, and I freely choose to participate.

Participant signature: ______________________________

Printed name: ___________________________

Date: __________________

Witness signature: ______________________________