CONFIDENTIALITY AND LIABILITY RELEASE AGREEMENT
(For Participation in The Sacred Breakthrough — Evolving Temple Psychedelic Retreat)
This Agreement is entered into between Evolving Temple, a project operated under Ignite International Co., Ltd. (the “Organizer”), together with its facilitators, assistants, partners, employees, and representatives (collectively, “Facilitators”), and the undersigned participant (“Participant”), for participation in The Sacred Breakthrough Psychedelic Retreat and its associated preparation and integration programs (collectively, the “Retreat”).
By signing this Agreement, the Participant acknowledges and agrees to the following terms:
1. Voluntary Participation
1.1 The Participant affirms that all participation in the Retreat is entirely voluntary. The Participant acknowledges that they are encouraged to ask questions and fully understand the psychological, emotional, and physical risks associated with all activities. The Participant further understands that they have the full right to decline or opt out of any activity at any time.
1.2 The Participant understands that the Retreat may include access to legal psychoactive plant materials permitted under Dutch law, such as psilocybin truffles or cannabis. Consumption of any such substance is entirely voluntary. The Participant acknowledges that Facilitators may offer guidance related to preparation, intention setting, and safety, although they do not administer these substances and are not liable for any psychological, emotional, or physical consequences arising from their use. The Retreat may also include voluntary practices such as breathwork, meditation, energy exercises, somatic work, and other reflective or self-development activities, and participation in each activity remains fully voluntary.
1.3 The Participant understands that these activities may induce altered states of consciousness, intense emotional or physical experiences, and potentially challenging psychological or spiritual processes. The Participant further understands that certain experiences, insights, emotional responses, or effects may continue or persist after the Retreat. Facilitators may offer guidance and support during the integration process; however, they do not assume liability for any ongoing, lasting, or delayed psychological, emotional, physical, or spiritual outcomes arising from participation.
1.4 The Participant understands that the focus of the Retreat is personal development and self-exploration. The Organizer and Facilitators make no therapeutic, medical, clinical, or psychiatric claims, and the Retreat is not presented or offered as any form of treatment or healthcare service.
1.5 The Retreat includes four individual preparation sessions of ninety minutes each and three group preparation sessions of one hundred twenty minutes each, focused on personal development goals, intention setting, and understanding what to expect during the Retreat. The in-person Retreat lasts for five days and includes five nights of accommodation, with all meals provided. Dietary needs will be accommodated to the best of the Organizer’s capacity. Following the Retreat, the program includes four individual integration sessions of ninety minutes each and three group integration sessions of one hundred twenty minutes each, focused on personal development goals, refining intentions, and integrating insights into daily life.
1.6 If the Participant wishes to receive any additional reflective or conversational support beyond the sessions included in the program, such additional sessions or services will be subject to separate fees.
1.7 The Participant confirms that they are signing this Agreement while fully sober, mentally capable, and able to make informed decisions. The Participant agrees that they will not sign this Agreement or participate in any part of the Retreat under the influence of any substance that impairs judgment or awareness.
2. Personal Responsibility and Assumption of Risk
2.1 The Participant assumes full responsibility for their physical, emotional, mental, and spiritual wellbeing during and after the Retreat. The Participant confirms that they hold valid travel and health insurance sufficient to cover any unforeseen circumstances, medical needs, or emergencies. The Participant understands that the Organizer and Facilitators are not responsible for any such costs and will not be liable for expenses arising from accidents, injuries, medical issues, transportation, or other unexpected events.
2.2 The Participant acknowledges that participation may involve physical exertion, psychological stress, emotional discomfort, or other unforeseen effects, and that such experiences are inherent to introspective and self-development processes.
2.3 The Participant releases the Organizer and Facilitators from any and all liability for any injury, illness (physical, mental, psychological, or emotional), loss, or damages of any kind arising from participation in the Retreat. This release applies to all activities before, during, and after the Retreat, except in cases of proven gross negligence or willful misconduct by the Organizer or Facilitators.
2.4 The Participant agrees that the Organizer makes no guarantees regarding any specific outcomes, changes, improvements, healing, transformation, or results of any kind arising from participation in the Retreat or its related activities.
2.5 The Participant understands that participation in the Retreat, including the voluntary use of psychoactive plant materials, breathwork, somatic practices, or any physically or emotionally intense activity, carries inherent risks. These risks may include serious physical or psychological harm, and in very rare cases, unforeseen events that could result in severe injury or death. The Participant voluntarily accepts all such risks and confirms full responsibility for their decision to participate. The Organizer and Facilitators are not liable for any such outcomes except where liability cannot legally be waived under applicable law.
2.6 The Participant agrees to follow all safety instructions provided by the Facilitators at all times. The Participant understands that refusal or failure to follow safety guidance may increase personal risk and may result in removal from the Retreat without refund.
3. Medical and Psychological Disclosure
3.1 The Participant certifies that they have fully and accurately disclosed all relevant medical and psychological history, including but not limited to:
Any psychiatric diagnoses or prior hospitalizations
All current medications, particularly antidepressants, antipsychotics, MAOIs, SSRIs, mood stabilizers, or any substance that may interact with psychoactive plant materials
Any cardiovascular conditions, seizures, diabetes, or other chronic illnesses
Any recent trauma, major emotional distress, or significant life events that may affect participation
3.2 The Participant agrees not to withhold any information that could reasonably affect their own safety or the safety of others, and acknowledges that withholding information may increase personal risk.
3.3 The Organizer reserves the right to decline or withdraw participation if any disclosed or undisclosed medical or psychological condition is deemed incompatible with safe participation. This decision is made solely for safety considerations and does not constitute a medical or psychological evaluation.
3.4 The Participant confirms that they have consulted, or had the opportunity to consult, a medical doctor or psychiatrist regarding the voluntary use of psychoactive plant materials such as psilocybin truffles or cannabis. The Participant understands that any decision to consume such substances is entirely voluntary and made at their own discretion and responsibility.
4. Medical and Emergency Responsibility
4.1 The Participant acknowledges that no licensed medical doctor, medical professional, or emergency medical service will be immediately present on site during the Retreat.
4.2 The Participant accepts full responsibility for any medical care, treatment, transportation, or evacuation that may become necessary and agrees to assume all related costs.
4.3 The Participant confirms that they carry sufficient travel and health insurance to cover any medical, emergency, or unforeseen circumstances that may arise, and understands that the Organizer and Facilitators are not responsible for such costs.
4.4 The Participant authorizes the Organizer to contact the emergency contact person provided by the Participant if, in the judgment of the Facilitators, such contact is necessary for the Participant’s safety or wellbeing.
5. Confidentiality and Privacy
5.1 The Participant agrees to maintain strict confidentiality regarding the identities, personal stories, and individual experiences of all other participants.
5.2 The Participant agrees not to record, photograph, or share any information in any format, including online posts, social media, or publications, that could reveal another participant’s presence, identity, or experience at the Retreat.
5.3 The Organizer agrees to maintain the confidentiality of all personal information disclosed by the Participant, except where disclosure is required by law or is necessary for immediate safety concerns.
5.4 All group discussions, sharing sessions, and activities are confidential spaces. Any breach of confidentiality may result in immediate dismissal from the Retreat without refund.
6. Conduct and Boundaries
6.1 The Participant agrees to follow all guidance provided by the Facilitators and to respect all retreat boundaries, including rules related to silence, substance use, diet, physical spaces, and interpersonal conduct.
6.2 The Participant understands that the use of alcohol, recreational drugs, or any unapproved substances is strictly prohibited during the Retreat.
6.3 The Participant acknowledges that failure to comply with these rules or any conduct that compromises the safety or wellbeing of the group may result in immediate removal from the Retreat without refund.
6.4 The Participant understands that certain moments during the Retreat may involve optional supportive touch provided by Facilitators, such as gentle grounding contact, hand placement, or guided physical reassurance intended to support nervous system regulation and activation of the parasympathetic response. The Participant confirms that they may give or withdraw consent to such touch at any time, verbally or nonverbally, and that all touch offered is non clinical in nature. The Participant agrees that the Facilitators are not liable for any reactions, interpretations, or outcomes related to such touch, and understands that participation in any touch based support is entirely voluntary.
6.5 The Participant agrees not to bring weapons, sharp objects, illegal substances, or any item that may pose a safety risk to the Retreat environment. Any violation of this clause may result in immediate removal from the Retreat without refund.
6.6 The Participant agrees to behave respectfully towards all individuals at the Retreat. Aggressive, inappropriate, or disruptive behaviour, or behaviour that endangers the safety or comfort of others, may result in immediate removal from the Retreat without refund.
7. No Medical, Psychiatric, or Religious Claims
7.1 The Participant acknowledges that the Retreat is not a substitute for medical, psychological, psychiatric, or clinical treatment. The Participant understands that the Facilitators do not provide medical, psychiatric, psychological, or clinical therapy in any form. All activities offered are for personal development and self-exploration only.
7.2 The Participant understands that the Retreat may include spiritual, reflective, or metaphysical content. Participation in such content is voluntary and does not imply endorsement of any religion, belief system, or ideology.
8. Waiver and Release of Liability
8.1 The Participant voluntarily assumes all risks associated with participation in the Retreat and fully waives, releases, and discharges the Organizer and all Facilitators from any and all claims, demands, liabilities, and causes of action of any kind arising out of or connected with participation in any component of the Retreat, whether occurring before, during, or after the Retreat.
8.2 This release applies to all injuries, illnesses, losses, or damages of any kind, including those resulting from ordinary negligence, accidents, acts of nature, unforeseen events, or the Participant’s own actions or decisions.
8.3 The Participant agrees that they will not initiate any claim, lawsuit, or legal proceeding against the Organizer or Facilitators in any jurisdiction for any matter related to participation in the Retreat, except where liability cannot legally be waived under the governing law applicable to the specific component of the Retreat.
8.4 The Participant understands that this waiver is intended to be valid and enforceable to the fullest extent permitted by the laws of any jurisdiction in which any part of the Retreat is accessed or attended.
9. Indemnification
9.1 The Participant agrees to fully indemnify and hold harmless the Organizer, all Facilitators, and their affiliates, employees, agents, and representatives from any loss, liability, claim, damage, or cost of any kind, including legal fees, arising out of or related to the Participant’s actions, choices, conduct, or participation in any component of the Retreat.
9.2 This indemnification applies to all activities conducted in the Netherlands, in Thailand, and through online platforms, and is intended to be enforceable to the fullest extent permitted by the laws of any jurisdiction in which any part of the Retreat is attended or accessed.
9.3 The Participant agrees that they are financially responsible for any harm, disruption, damage, or risk they cause to themselves, to other participants, to property, or to the overall safety and functioning of the Retreat.
10. Media, Photography, and Recordings
10.1 The Participant agrees not to use any recording device, including cameras, mobile phones, video equipment, or audio recorders, during any part of the Retreat unless explicitly permitted by the Organizer.
10.2 The Organizer will not record, photograph, or share any aspect of the Participant’s experience without the Participant’s prior written consent.
10.3 The Participant agrees that any unauthorized recording or sharing of retreat content, activities, or other participants may result in immediate removal from the Retreat without refund and may give rise to legal action where applicable.
10.4 The Participant is solely responsible for their personal belongings, valuables, equipment, and any items brought to the Retreat. The Organizer and Facilitators are not liable for any loss, theft, or damage to personal property at any time.
11. Refund, Transfer, and Cancellation
11.1 The Participant acknowledges that all retreat fees are nonrefundable. Any exceptions, such as transfer options, postponement, or credit policies, are governed exclusively by the Retreat Terms and Conditions issued by the Organizer. The Participant agrees to review and accept those Terms and Conditions as part of this Agreement.
11.2 The Participant understands that no refunds, credits, or compensations of any kind will be issued in cases of early departure, failure to attend any portion of the Retreat, or removal due to violation of retreat rules, conduct guidelines, or safety boundaries.
11.3 The Participant agrees that travel delays, personal scheduling conflicts, illness, dissatisfaction with any aspect of the program, or changes in personal circumstances do not constitute grounds for a refund.
11.4 The Participant is fully responsible for arranging and managing their own travel, transportation, visas, and logistical requirements necessary to attend the Retreat. The Organizer is not responsible for travel delays, cancellations, border issues, missed transportation, or any related disruptions.
12. Legal Jurisdiction
12.1 This Agreement applies to every component of the Retreat, including activities conducted in the Netherlands, activities conducted in Thailand, and all preparation and integration sessions delivered online or in any other location.
12.2 All activities that take place physically in the Netherlands are governed by the laws of the Netherlands. All activities that take place physically in Thailand, together with all company operations, are governed by the laws of Thailand. All online activities are governed by the laws of the jurisdiction in which the Organizer is registered, which is Thailand.
12.3 The Participant agrees that this Agreement is intended to be valid, binding, and enforceable to the fullest extent permitted by the laws of every jurisdiction in which any part of the Retreat is attended or accessed. If any portion of this Agreement is found to be unenforceable in one jurisdiction, the enforceable portions shall remain fully valid in all other jurisdictions.
12.4 Any legal dispute arising from activities conducted within the Netherlands shall be resolved exclusively in a competent court located in the Netherlands. Any legal dispute arising from activities conducted in Thailand, or relating to the Organizer as a Thai company, shall be resolved exclusively in a competent court located in Thailand.
12.5 The Participant agrees that they will not bring legal action in any other jurisdiction outside of those specified above, and that any attempt to initiate proceedings in another jurisdiction is expressly waived to the fullest extent permitted by law.
13. Acknowledgment and Acceptance
13.1 By signing below, the Participant confirms that they have carefully read and fully understood all terms of this Confidentiality and Liability Release Agreement, including the sections related to assumption of risk, waiver of liability, indemnification, and jurisdiction.
13.2 The Participant affirms that they are entering into this Agreement voluntarily, of their own free will, without pressure, coercion, or undue influence.
13.3 The Participant confirms that they have had the opportunity to ask questions, seek clarification, and consult independent advice if desired before signing.
13.4 The Participant acknowledges that they have provided complete and truthful medical and psychological information and understand that failure to do so increases personal risk and may void participation.
13.5 The Participant accepts full responsibility for their physical, emotional, mental, and spiritual wellbeing before, during, and after the Retreat, and agrees to comply with all retreat guidelines and boundaries.
13.6 The Participant agrees that their signature constitutes a binding legal agreement enforceable in all relevant jurisdictions as described in this document.
13.7 The Participant agrees that this Agreement may be signed electronically, and that any digital signature, typed name, electronic check mark, or other form of electronic acceptance has the same legal validity and enforceability as a handwritten signature. The Participant acknowledges that their electronic confirmation constitutes full agreement to all terms of this document.
