Kush Klinic Membership Agreement

Rules and Regulations Agreement.

It is the policy of the Kush Klinic to update our rules and regulations from time to time to reflect changes in the law. It is your responsibility to keep an up to date recommendation. Our staff members are not expected to remind you of your expiration date. The following rules and regulations are strictly enforced at all times:

It is understood by all parties that membership in Kush Klinic is a privilege not a right. Kush Klinic members must be 18 years of age or older.

  1. Membership may be revoked at anytime by management or the Board of Directors for violation of any action not covered by the rules and regulations that, in the opinion of the Board of Directors or the management, brings discredit, unwelcome public attention or unwanted burden to our collective. 
  2. Except for Kush Klinic staff and management, the operation of cell phones, recording devices and cameras is prohibited in all Kush Klinic facility at all times.
  3. No person shall accept deliveries from Kush Klinic or enter the private areas of Kush Klinic facilities without a valid recommendation for medical cannabis, as well as a valid California State issued Identification Card or Kush Klinic identification card.
  4. Loitering is not allowed at or in front of any Kush Klinic facilities at any time.
  5. Members agree NOT to sell or attempt to sell any medical marijuana acquired from Kush Klinic.
  6. Members are allowed to walk in only three times per day.
  7. Members agree abide by all requirements and restrictions regarding medical cannabis as set forth in Prop 215, SB420, California Health and Safety Code sections 11362.5 and 11362.7 et seq. and all local regulations.
  8. Members agree NOT to operate motor vehicles or other mechanical devices while medicated.
  9. Members must NOT bring any weapons or anything that can be used as a weapon to any Kush Klinic staff member. Pocketknives, tools etc. must be left in your vehicle or surrendered to Kush Klinic volunteers or security while on the premises.


  1.  I am a qualified patient or Primary Caregiver pursuant to the laws of the State of California with a current recommendation from a licensed physician.
  2.  I certify under the penalty of perjury I am not an law enforcement official, officer or agent. I am not signing this agreement nor joining Kush Klinic or purchasing medical cannabis for any law enforcement purpose.
  3. I have read, I understand and I agree to the Kush Klinic Regulations Agreement and I consent to joining this collective pursuant to the terms set forth in the agreement.
  4. I certify under the penalty of perjury that the information provided on this agreement is true and accurate and that I am not seeking membership in Kush Klinic for any fraudulent purpose.
  5. I will not distribute any medicine received from Kush Klinic to any other person, and I shall use it for medical purposes only.
  6. I authorize my recommending physician to verify his or her recommendation, authorization or approval for my use of medical cannabis.
  7. I authorize and assign to Kush Klinic, on my behalf, to possess, and distribute to Kush Klinic members who are qualified patients up to (8) eight ounces of medical cannabis and 6 cannabis plants afforded to me pursuant to Health and Safety Code section 11362.5 et seq.


  1. First No Show – $35 FEE on Next Order
  2. Second No Show – $50 FEE on Next Order
  3. Third No Show – BANNED FOR LIFE

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Signature Certificate
Document name: Kush Klinic Membership Agreement
lock iconUnique Document ID: 6a145e29d88a2623f528b5b71e9749c7d8984406
Timestamp Audit
July 4, 2019 6:01 AM PDTKush Klinic Membership Agreement Uploaded by Kush Klinic Administrator - info@kushklinic.com IP