Membership Agreement

I (the undersigned member), declare, understand, acknowledge and/or agree as follows:

I voluntarily choose to be a non-voting member of Mystic Blue Holistics Collective & Delivery, and upon my membership acceptance by Mystic Blue Holistics authorized representative's signature below, I will follow and/or abide by all rules and regulations of membership set forth by the Collectives administrative staff dully appointed and/or hired by Mystic Blue Holistics Collective Governing Body. Such Rules & Regulations of membership shall be posted on the Collectives website at www.MysticBlueHolistics.com and by signing this agreement I agree to said membership rules and regulations under Mystic Blue Holistics Collective Member Code of Conduct, and it is my sole responsibility to read and be aware of them.

As a qualified patient protected by California State Law, Health and Safety Code 11362.5 and 11362.7, et seq., and in conjunction with California State Senate Bill 420, you are required to read and agree to the following statements to become a member of Mystic Blue Holistics Collective & Delivery. Please understand that these are for your protection as well as ours. Please read the following statements and mark that you understand each statement and sign the bottom of this form.

1. I hereby declare that I am over the age of 18 and a qualified medical marijuana patient under California Health and Safety Code §11362.5 and §11362.7, et seq., and a physician licensed by the California State Board of Medicine has recommended and approved my use of medical marijuana for a chronic illness. As per California Health and Safety Code §11362.51, I am legally able to use, possess, transport and cultivate cannabis for medical purposes. I understand that I am allowed to do so through safe and affordable access such as the type offered by Mystic Blue Holistics Collective & Delivery, Inc*

YESNo

2. I hereby certify and agree that I am a California resident with a valid California Identification Card or Driver’s License and that my personal medical marijuana will not be taken out of the State of California. I further verify and agree that my medical marijuana shall not be sold, redistributed, shared, bartered, traded, exchanged or delivered in any other means to any person except to other members on behalf of Mystic Blue Holistics Collective & Delivery, Inc. I further agree not to use the medical marijuana or other cannabis products for anything other than medical purposes*

YESNo

3. I will read and familiarize myself with California Health and Safety Code §11362.5, also known as “The Compassionate Use Act” or Proposition 215; §11362.7-§11362.84, also known as “The Medical Marijuana Program Act (MMP),” or Senate Bill 420; and the Attorney General’s, “Guidelines to Ensure the Security and Non-Diversion of Marijuana Grown for Medical Use”. As a qualified medical marijuana patient of the State of California and a member of Mystic Blue Holistics Collective, I agree to know and follow those laws and the Attorney General’s guidelines. Failure to comply with the law and the Attorney General’s guidelines may result in termination of membership*

YESNo

4. As a member, I understand that Mystic Blue Holistics Collective has other members with similar Membership Agreements. I hereby authorize Mystic Blue Holistics Collective to jointly possess the medical marijuana as described under this Agreement jointly with other Mystic Blue Holistics Collective members under similar Membership Agreements. I agree the medicinal marijuana possessed by Mystic Blue Holistics Collective at anytime is the collective property of every patient who is also under the Membership Agreement and the care of Mystic Blue Holistics Collective & Delivery, Inc*

YESNo

5. As a medical marijuana patient and member of the Collective, I hereby agree, appoint and designate Mystic Blue Holistics Collective & Delivery, Inc. and their representitives, as my true and lawful agents for the limited purpose of assisting me in obtaining my legally recommended medicinal marijuana as a member of Mystic Blue Holistics Collective. I understand that this means Mystic Blue Holistics Collective & Delivery, Inc. will be required to enter into legal contracts on my behalf in order to cultivate, purchase, possess, transport and distribute my medicinal marijuana in whatever form to me as recommended by my Physician and I grant them the limited authority to do so. I further authorize Mystic Blue Holistics Collective & Delivery, Inc. to enter into contracts on my behalf which would be to the general benefit of the Collective and in order to obtain and/or allow growth/preparation of medication, tinctures, topicals and edibles on my behalf*

YESNo

6. I do hereby acknowledge and agree to pay all personal out-of-pocket expenses and reasonable compensation for Mystic Blue Holistics Collectives member services and/or products. I hereby declare and understand that my contributions to Mystic Blue Holistics Collective & Delivery, Inc. for and through medicinal services are used to cover overhead expenditures required to ensure the continued operation of the Collective and that any said transaction in no way constitutes a commercial promotion or sale of any item*

YESNo

7. I hereby declare and understand that members must be physically home at the time of delivery and must be the only person at the door when drivers make contact. Deliveries can only be carried out at a private location. This generally means a home or office. I also understand that I must have a valid ID available for presentation at the door for every delivery in order to receive medicinal marijuana products from Mystic Blue Holistics Collective & Delivery, Inc. There will be no exceptions*

YESNo

8. I agree to possess my original, or a current and valid copy of my physician’s recommendation when I am receiving deliveries of medical marijuana products from Mystic Blue Holistics Collective & Delivery, Inc. I understand that my failing to do so may result in refusal of services. I hereby agree that any violation of the terms of this Agreement or any other Collective rules are grounds for immediate termination of membership*

YESNo

9. As a Collective Member, I agree to sign and follow all Mystic Blue Holistics Collective & Delivery, Inc. rules and regulations regarding their services. I understand that the Membership Agreement may change and I hereby agree to all future changes of these policies through verbal or written notices, as the laws for safe access develop. I agree that Mystic Blue Holistics Collective & Delivery, Inc. rules and regulations are strictly enforced. Any violtaions of the terms of this Membership Agreement, or any other Mystic Blue Holistics Collective & Deliver, Inc. rules are grounds for immediate termination of membership*

YESNo

10. I agree to provide Mystic Blue Holistics Collective & Delivery, Inc. with all changes in my contact information, diagnosis, primary physician, or any other applicable information immediately. As a member of the Collective, it is my responsibility to keep my recommendation and information current to avoid refusal of services*

YESNo

I hereby affirm that I have read, understand and agree to the Terms of the Mystic Blue Holistics Collective & Delivery, Inc. Membership Agreement... Type your name below to acknowledge the agreement. You will also sign an original copy for our records before your first delivery.*

Enter date and time you "signed" this agreement*

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Mystic Blue Holistics Collective Membership Agreement