Jet Room

Membership Agreement


 

We encourage our patients that have not yet obtained a proper medical recommendation or MMC to visit www.sbmedi.com to learn more about obtaining your medical marijuana license. 

 

 Jet Room, Inc. is a California State and City of Adelanto licensed Medical Adult Use Cannabis Regulation & Safety Act (MAUCRSA) Dispensary.

I, ,  hereby declare and agree as follows:

I am a qualified patient entitled to the protection of California Health and Safety Code section 11362.5, et seq. and the Medical Adult Use Cannabis Regulation & Safety Act (MAUCRSA) because my physician has recommended/approved my use of cannabis for medical purposes.

 

  • My physician has determined that I suffer from a medical condition for which medical cannabis provides relief and has provided a written recommendation that verifies this fact. (INITIAL HERE)

 

  • In order to acquire the medical cannabis I hold a valid California Medical ID Card and physician’s recommendation, and in accordance with California Health and Safety Code section 11362.5, et seq., I hereby seek membership in the Jet Room,Inc. and understand that in order to be a member, I agree to, and follow all terms and conditions set forth in this agreement, including obtaining a State Medical Cannabis ID Card issued by the Department of Public Health at County offices. (INITIAL HERE)

 

  • I agree and understand that all medical cannabis obtained is for medical use only and may not be diverted for non-medical use or for use by anyone other than myself.  (INITIAL HERE)

 

  • I understand that my medical cannabis recommendation may be disclosed pursuant to any required audits by any Government agency for purposes of verifying the compliance with the Medical Adult Use Cannabis Regulation & Safety Act (MAUCRSA), Compassionate Use Act, the Medical Marijuana Program Act, the Attorney General Guidelines, or any local ordinance. I understand that the Jet Room, Inc. may maintain records of my medical use in order to demonstrate compliance with the aforementioned Acts, the Attorney General Guidelines, or any local ordinance, and further, that the Jet Room, Inc. will take all legal steps necessary to keep such records private and confidential, subject to the need of the Jet Room, Inc. to use such records to defend itself and establish that the conduct of the Jet Room, Inc. and its members did not violate the law.  (INITIAL HERE)

 

  • As a member of the Jet Room, Inc. I recognize that there are risks inherent in the use of medical cannabis. Jet Room Inc.is not responsible for the effects and makes no representation or warranties, express or implied, with regard to the safety, effect or efficacy of the medical cannabis I may obtain from the Jet Room, Inc. when used by itself or with other medicine.   (INITIAL HERE)

 

  • I hereby release, waive and discharge the Jet Room, Inc. including its officers, agents, employees, managers, independent contractors, parent organizations, subsidiaries, affiliate, and other personnel (“Releases”) from, and agree and covenant not to sue Releases for, any claim, liability, or demand of any kind or on account of any personal injury, temporary or permanent disability, death, property damage, or other damages, whether caused by medical cannabis or the negligence of Releases or otherwise, resulting from on in any way associated with my presence on the premises Collective’s facilities, amenities, or services. Further, I agree and covenant to indemnify Releases for, and hold Releases harmless, from any such claims, liabilities, or demands.  (INITIAL HERE)

 

  • I, , declare under penalty of perjury under the laws of the State of California that the information provided on this membership agreement is true and correct that I am a medical cannabis patient and I will not divert my medical cannabis for non-medical use or for use by anyone. I declare under penalty of perjury under the laws of the State of California that I am not a member of law enforcement and will not divert any medicine for the purpose of any criminal investigation.

 

  • I have read and understand the above requirements and agree to follow these guidelines.

 

I hereby authorize the release of my medical information concerning my diagnosis, condition or prognosis to the Jet Room, Inc. and its authorized representatives for purposes of verifying the validity of my medical recommendation and the valid operation of the Jet Room pursuant to the Compassionate Use Act, Medical Marijuana Program Act and Medical Adult Use Cannabis Regulation and Safety Act ( MAUCRSA)

 

MEMBER NAME:        DATE: 

MAILING ADDRESS:        CITY:  STATE:    ZIP:   

TELEPHONE NUMBER :  

TYPE OF STRAIN(S) NEEDED:                                                                                      

AMOUNT OF MEDICINE NEEDED/MONTH(APPROX.):         

   

     

We encourage our patients that have not yet obtained a proper medical recommendation or MMC to visit www.sbmedi.com to learn more about obtaining your medical marijuana license.                                                                        

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Signature Certificate
Document name: Membership Agreement
Unique Document ID: e6b8637cf596ce4515584a0d6ea2a887cf1ec396
Timestamp Audit
March 16, 2018 1:45 AM PSTMembership Agreement Uploaded by The Jet Room - dlaunte@protommail.com IP 155.186.114.88
March 17, 2018 3:15 AM PSTDelivery Jetroom - delivery@jetroom.com added by The Jet Room - dlaunte@protommail.com as a CC'd Recipient Ip: 155.186.114.88
March 17, 2018 3:15 AM PSTIT Department - dlaunte@jetroom.com added by The Jet Room - dlaunte@protommail.com as a CC'd Recipient Ip: 155.186.114.88
March 17, 2018 3:26 PM PSTDelivery Jetroom - delivery@jetroom.com added by The Jet Room - dlaunte@protommail.com as a CC'd Recipient Ip: 155.186.114.88
March 17, 2018 3:26 PM PSTIT Department - dlaunte@jetroom.com added by The Jet Room - dlaunte@protommail.com as a CC'd Recipient Ip: 155.186.114.88
March 17, 2018 3:41 PM PSTDelivery Jetroom - delivery@jetroom.com added by The Jet Room - dlaunte@protommail.com as a CC'd Recipient Ip: 155.186.114.88
March 17, 2018 3:41 PM PSTIT Department - dlaunte@jetroom.com added by The Jet Room - dlaunte@protommail.com as a CC'd Recipient Ip: 155.186.114.88