• I understand that even though I have agreed to participate in the session, I am responsible for any consequences resulting from my participation in the Cacao Ceremony.

• I understand that a cacao ceremony is a holistic, heart-centered practice that may include guided meditation, intention setting, somatic awareness, reflective dialogue, and the consumption of ceremonial cacao. I acknowledge that this experience is not a substitute for medical, psychological, or psychiatric treatment, diagnosis, or therapy.

• I certify that I have sought medical advice regarding any physical, mental, or emotional condition that may impair my judgment or have any effect on my physical health, and I am able to safely participate in the ceremony.

• I understand that cacao contains natural stimulants (including theobromine) and may not be appropriate for individuals with certain medical conditions such as heart conditions, high or low blood pressure, sensitivity to caffeine or stimulants, pregnancy, or those taking certain medications.

• Contraindications Checklist

  Please view the following list:

☐ Heart conditions or cardiovascular concerns
☐ High or low blood pressure
☐ Pregnancy or breastfeeding
☐ Sensitivity to caffeine or stimulants
☐ Current use of antidepressants, MAO inhibitors, or other medications
☐ Severe anxiety, panic disorder, or psychiatric condition

If any of the above apply, I understand it is my responsibility to consult with a medical professional and inform the facilitator before participating to adjust dosage or discuss ceremony alternatives.

• If I am taking any medications or have any medical conditions, I must discuss them with the facilitator prior to the session.

• I understand that participation may involve emotional release, shifts in mood, or heightened awareness. While cacao is generally considered gentle, individual experiences may vary.

• I understand that I am responsible for preparing and consuming cacao at my own discretion and agree not to exceed the recommended dosage provided by the facilitator.

• I understand and acknowledge that a Cacao Ceremony:

• a) Is not intended to replace any relationship with my medical doctor and/or primary health care provider(s).

• b) Is not intended to constitute medical advice or be a substitution for medical care; it is not intended to be relied upon for prescriptions, recommendations, diagnosis, or treatment in relation to any health problem or disease.

• I understand that while every care is taken, the facilitator will not be liable for any damage, reaction, or injury resulting from my participation.

• I understand and acknowledge that by participating in the ceremony, I am doing so at my own risk. I voluntarily execute this release and waiver with this understanding.

• I request that all information discussed in the session be kept confidential. This means that I may not discuss the identity, identifying information, or reactions of any participant with anyone outside of the session. I may talk about my own personal experience, but not others’ identifying information or reactions.

By confirming below, I am agreeing to these terms.