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As a qualified patient protected by California Law, Health and Safety Code 11362.5 & 11362.1 et seq., and in conjunction with California State Bill 420, you are required to read and agree to the following statements to become a member of the Orghani Naturals Cooperative, herein after "the Association"
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YES
I agree, if accepted to join the Association that any and all medical marijuana provided to me by the Association shall not be distributed to unqualified patients and distribution of medical marijuana to unqualified patients is grounds for immediate termination of my membership.
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YES
I was diagnosed with a "serious medical condition" that substantially limits my ability to conduct one or more major life activities for which the use of marijuana provides relief.
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YES
I acknowledge that my contributions are used to ensure continued operation of the Association and are applied toward future harvests of the Associations medicine. The medicines I acquire during my membership are indicative of what I require in the future and my contributions will be used to produce that amount of medicine on my behalf.
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YES
By Signing below, I hereby authorize my recommending physician to release information regarding my diagnosis and condition to the Association.
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YES
I consent to the benefits provided by the Association and agree to abide the Bylaws, rules, and regulations of the Association.
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YES
I am informed that membership in the Association is a private membership organized under Chapter 1 of Division 20 of the California Food and Agricultural Code and that if accepted; my membership alone does not warrant legal use of Marijuana.
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YES
I have been informed & understand that acceptance of my application is at the Association reserves the right to refuse my membership.
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YES
I understand that as a qualified patient I have the California State Constitutional right to use medicinal marijuana if recommended by a licensed medical physicians in good standing. Furthermore, I acknowledge and accept as true that medical marijuana, although an effective therapeutic agent is illegal under federal law and thereby membership and the submission of an application to join the Association are acts inconsistent with federal law.
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YES
Reason for Medical Marijuana
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Anxiety
Stress
Insomnia
Cancer
Other
***Email your CA ID to PatientRegistration@Orghani.com
***Email You Doctor's Medical Marijuana Recommendation
to PatientRegistration@Orghani.com
As a member of Orghani Naturals Cooperative, herein "the Cooperative," you know that medical marijuana has been legalized for use only by qualified members and primary caregivers. The Cooperative relies on our members to cultivate and provide medical marijuana. However, as these laws are new and changing, our state government has not provided us regulations on the quality control or procedures for the cultivation of medical marijuana. In obtaining medical marijuana, we members of the Cooperative take care to provide you medicine free from all toxins. In consideration of receiving membership and participating in the Cooperative we ask that you hereby release, waive, discharge, and covenant not to sue the Cooperative, its officers, servants, agents, and employees (herein after referred to as "releases" from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or relating to any loss, damage, or injury, including death, that may be sustained by you, whether caused by negligence of the release's or otherwise while a member of the Cooperative or while in, on, or upon the premises of the Cooperative. I am fully aware of risks and hazards connected with obtaining and using medical marijuana or edibles provided to me by the Cooperative, and I am fully aware that there may be risks and hazards unknown to me. I voluntarily assume full responsibility for any risks of loss personal injury, including death that may be sustained by me as a result of me being a member of the Cooperative. I further hereby agree to indemnify and save and hold harmless the releases and each of them, from any loss, liability, damage, or costs they may incur due to my participation in the cooperative, whether caused by the negligence of any or all of the releases or otherwise. Its is my express intent that this release shall bind the members of my family and spouse if I am alive, and my heirs, assigns, and personal representatives if I am deceased, and shall be deemed as a Release, Waiver, Discharge, and Covenant not to sue the above named release's. In signing this Release, I acknowledge and represent that: I have read the forgoing release, understand it and sign it voluntarily as my own free act and deed. No oral representations, statements, or inducements, apart from the forgoing written agreement, have been made. I am at least eighteen (18) years of age and fully competent. I execute this Release for full, adequate, and complete consideration fully intended to be bound by the same.
I Have Read The Above
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I UNDERSTAND AND AGREE
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Once submitted, your information will be verified. Your login information will be sent to the email listed above after review. You may then place your order online. Please allow up to 1 hour for verification. If you need immediate attention, please call 925-329-9618 after registration or email us directly at Support@Orghani.com
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