I understand that Safe Flight Limited dba ONE Retreats Jamaica and its facilitators, officers, directors, employees, contractors, agents and/or representatives (“Team”) intend to make the psilocybin retreat (“Retreat”) I am participating in a safe and productive experience for all. I understand the screening process enables the Team to be informed of physical and mental health conditions that would prevent my safe participation in the Retreat. I understand that the Team does not provide any health care services, and that any screenings performed are not medical evaluations, nor are they intended to assess any individual’s risk of experiencing side effects or identify what those specific side effects may be.

I understand that the services provided by the Team at the Retreat as requested by you or as a part of the Retreat program (“Services”) are not therapy or psychological counseling and are not a substitute for the treatments or services ordinarily provided by health care professionals for physiological or psychological complaints. If I need or desire medical treatment, therapy, or psychological counseling, I will seek it from a licensed provider or attend at a local hospital.

I am well physically, psychologically, and emotionally, and I commit to being responsible for my own well-being during the course of any Services received.

I agree that the Services aren’t designed to treat any person for any physical or mental condition or illness. The Team are not practicing medicine, diagnosing, curing, or treating disease or illnesses or administering, prescribing, or providing, prescription drugs or illegal substances.

I understand that the Team are not my therapist, counselor or psychotherapist. Further, I agree to notify the Team immediately if any of the representations I made change. I also agree that I understand that no illegal substances will be provided by the Team.

By signing this Form I am further confirming and agreeing that I have:

(a) no heart condition or blood pressure issue of which I am aware;

(b) no known cardiovascular disease, including but not limited to moderate hypertension, valvular heart disease, or other conditions that may be contraindicated to psilocybin;

(c) not been diagnosed with, or suffer from as far as I am aware, borderline personality disorder, psychosis, schizophrenia or any bipolar-related disorders;

(d) not been diagnosed with, or suffer from as far as I am aware, suicidal thoughts or feelings.

I have voluntarily disclosed all of the information contained in my responses on this Intake Form and I authorize the Team to share my responses with Team members for the limited purposes described above. I understand that the Team will not disclose my Responses to any third party, unless I specifically authorize them to do so. I understand that theTeam will retain my responses after concluding the screening process and Retreat.

I agree to indemnify, defend and hold harmless the Team from any injury, adverse effect, illness or otherwise that I may suffer or others may suffer at my hands and all claims, damages, liabilities, costs, and expenses that may arise whether from me or any third party connected to me from my participation on this Retreat or a breach of the agreements, understandings and warranties I have provided in this Release