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Photo of California issued ID/Driver's License:
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Doctor's recommendation for medical marijuana:
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Membership Agreement Form:
SILICON VALLEY FARMS, Inc.
Medical Marijuana Collective Membership AgreementI, , hereby declare that I am a qualified patient entitled to the protection of California Health and Safety Code § 11362.5, and 11262.7 et seq., and my doctor has recommended and approved my use of medical cannabis (marijuana).
My physician, , has determined that I benefit from the use of cannabis to treat my medical condition. My physician has provided a written recommendation letter that I use cannabis to treat cancer, anorexia, AIDS, chronic pain, spasticity, seizures, severe nausea, glaucoma, arthritis, migraine, or any other illness for which marijuana provides relief. The letter of recommendation contains all the information required by Health and Safety Code §11362.715.
Upon signing this document, I elect to become a member of the medical marijuana collective, Silicon Valley Farms, Inc., and agree to all terms contained in this agreement.
As a qualified medical marijuana patient under the Compassion Use Act of 1996 and the Medical Marijuana Program Act, I choose to join and participate in the collective association, Silicon Valley Farms, Inc. (hereinafter referred to as SVF). SVF is an association of qualified medical marijuana patients formed in order to collectively cultivate marijuana for medical purposes pursuant to the Medical Marijuana Program Act, which was enacted by the People of the State of California to promote uniform and consistent application of the Compassionate Use Act among counties within the state, and to enhance the access of patients and caregivers to medical marijuana through collective and cooperative cultivation projects.
As a member of SVF, I understand and agree that each and every member of this collective will contribute labor, funds, supplies, services, and/or materials to collectively cultivate marijuana for medical use.
I understand that SVF is a California Mutual Benefit Nonprofit Corporation formed to provide safe access to affordable medicine for all members of the collective. None of the collective members, including myself, shall profit from the sale or distribution of medical marijuana.
As a member of SVF, I understand that all medical marijuana possessed by the collective is jointly owned by all members of the collective. I own a portion of the medical marijuana possessed by the collective at all times. I authorize SVF to cultivate, transport, and possess medical marijuana on my behalf. I also authorize SVF to distribute my medicine to other members of our collective. A copy of my medical marijuana recommendation may be posted at an SVF garden. Medical marijuana possessed by SVF has been cultivated by its members on behalf of its members. No medicine will be transferred to any person outside of our collective.
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SILICON VALLEY FARMS, Inc.
Medical Marijuana Collective Membership AgreementPlease answer each of the following questions:
- You are a : Patient Caregiver
- Are you an adult California resident MMJ qualified patient or primary caregiver?
- Have you had a membership in this organization terminated by removal or expulsion within the last five years, except if removed solely for non-payment of fees or dues and have since paid all sums past due?
- Have you had a membership in any other medical cannabis cooperative or collective terminated or been expelled for cause within the last five years in any other medical cannabis cooperative , except if removed solely for non-payment of fees or dues?
- Have you been convicted of any drug related felony within the last 5 years, including violation of Section 11351, 11351.5, 11352, 11355, 11359, 11360, 11378, 11378.5, 11379, 11379.5, 11379.6, 11380, 11382, or 11383 of the Health and Safety Code, or Section 182 of the Penal Code, or a felony violation of Health and Safety Code Section 11366.8, insofar as the offense involves manufacture, sale, possession for sale, offer for sale, or offer to manufacture, or conspiracy to commit one of those offenses?
SILICON VALLEY FARMS, Inc.
Medical Marijuana Collective Membership Agreement
You are applying to be an adjunct member of Silicon Valley Farms (SVF). If accepted as a member, you must agree to the terms of membership as set forth in the Bylaws. You acknowledge that you have read the terms and conditions on the reverse side and are aware of the legal consequences of this agreement, including that you are prevented from suing the Collective or its employees, agents or officers if you are injured or damaged for any reason as a result of participation as a member and/or in any membership activity and/or a result of use or possession of products (including cannabis) received as a member.
Read the following before joining Silicon Valley Farms, Inc. and associating with your fellow members. Silicon Valley Farms, Inc. (SVF) is a not-for-profit, mutual benefit corporation. SVF is composed entirely of legally qualified medical cannabis patients and caregivers who have chosen to associate to enhance the development of physical, mental, and emotional fitness of its members, find solutions for, and share knowledge of the health problems of its members, and to facilitate and/or coordinate the cultivation and distribution among the members of herbal remedies including cannabis for medical purposes as lawfully permitted under the laws of the State of California, including but not limited to the cultivation of medical cannabis (CA H&S 11362.775). Read and understand the Articles of Incorporation and Bylaws, copies of which are always on public display in the Collective. A copy of this application and Collective's Articles and Bylaws will be furnished without charge to any member or prospective member upon reasonable request. Members have other inspection rights as well.
In order to be member and maintain membership, you must qualify, and maintain that qualification. Minimum qualification includes that: a) That at all times you are an adult California resident qualified patient or primary caregiver; b) You abide by the Bylaws and Rules and Regulations of SVF and the laws of the State of California as it pertains to medical cannabis; c) You timely pay all contributions, dues, assessments and/or fees; d) You refrain from distribution of cannabis received from SVF to non-members, use for other than medical purposes, and for any use for an unlawful purpose; e) You not suffer conviction of any drug related felony within the last 5 years, including violation of Section 11351, 11351.5, 11352, 11355, 11359, 11360, 11378, 11378.5, 11379, 11379.5, 11379.6, 11380, 11382, or 11383 of the Health and Safety Code, or Section 182 of the Penal Code, or a felony violation of Health and Safety Code Section 11366.8, insofar as the offense involves manufacture, sale, possession for sale, offer for sale, or offer to manufacture, or conspiracy to commit one of those offenses; f) You belong only to this Collective and no other Collectives or Cooperatives, without our consent. Acceptance of your membership and access to the product and services of SVF is expressly conditioned upon truthful information having been provided in this application. The representations made in this application by you will be used as true. You are associated with other SVF members and to faithfully follow and obey all SVF Bylaws, Rules and Regulations, and the laws of the State of California as it pertains to medical cannabis. You agree to immediately report to SVF any circumstances affecting your qualification. As a member you are agreeing that the Collective may facilitate and/or coordinate the cultivation and distribution of medical cannabis jointly and collectively for the members, including by cultivation and possession of medical cannabis on your behalf. You agree to accept notice of membership matters by electronic transmission. The e-mail address provided on this application may be sued as the address on record of the member, until changed in writing by the member.
ASSUMPTION OF RISK You acknowledge and understand that you are participating in membership activities and using the services of SVF, as well as products received, used or possessed (including cannabis) at your own risk. SVF and the members, officers, employees, agents, contractors and affiliates of the Collective shall not be liable--and you hereby expressly waive any claim of liability--for personal/bodily injury or damages--which occur to you, for any and all loss or injury to person or property. This waiver is intended to be a complete release of any responsibility for personal injuries and/or property loss/damage you sustain arising from membership activities, arise from use of services or facilities, and/or arise from possession or use of products (including cannabis) obtained as a member, and/or occur while on SVF Premises of the Collective, whether using services or products or not. In consideration of being permitted to participate as a member and/or in any member activity, and/or use of any SVF facilities, and/or use or possession of any product received as a member (including cannabis), in connection with this membership or membership activity or use or possession, you agree to the following: 1. YOU HEREBY RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE SVF, ITS EMPLOYEES, OFFICERS AND AGENTS (hereinafter referred to as 'releasees') from all liability to you, your personal representatives, assigns, heirs and next of kin for any loss, damage, or claim therefore on account of injury to your person or property, whether caused by any negligent act or omission of the releasees or otherwise while you are participating as a member and/or membership activity and/or using any SVF facilities in connection with the activity and/or using or possessing any product received as a member of SVF (including cannabis). 2. YOU HEREBY AGREE TO INDEMNIFY AND HOLD HARMLESS the releasees from all liability, claims, demands, causes of action, charges, expenses, and attorney fees resulting from your involvement in this membership or membership activity or by use or possession of any product received as a member of SVF (including cannabis) whether caused by any negligent act or omission of the releasees or otherwise. 3. YOU HEREBY ASSUME FULL RESPONSIBILITY FOR AND RISK OF BODILY INJURY, DEATH OR PROPERTY DAMAGE while upon SVF property or participating in membership activity or by use or possession of any product received as a member of SVF (including cannabis) whether caused by any negligent act or omission of releasees or otherwise. You expressly agree that the foregoing release and waiver, indemnity agreement and assumption of risk are intended to be as broad and inclusive as permitted by California law. You acknowledge that you are not relying upon any representation by SVF or any agent of SVF as to your suitability to engage in membership activities and/or the suitability or condition of any products received used, or possessed (including cannabis) by you. You expressly agree that you are relying exclusively upon your own judgment and opinions and/or those of your health care providers or other professionals as to your suitability to engage in membership activities and/or the use or possession of products (including cannabis) and/or condition of any products (including cannabis) received used, or possessed by you.
SILICON VALLEY FARMS, Inc.
Medical Marijuana Collective Membership AgreementSilicon Valley Farms, Inc. exists to provide safe, local, affordable access to cannabis for those who qualify for its use. We want to insure safety and well being for our members and surrounding community members. In the interest of our collective members and neighbors, please read these rules and adhere to them at all times. Thank You.
- Our collective will only cultivate, possess, transport, and distribute medicine within the guidelines of Proposition 215, Senate Bill 420, and the Attorney General's Guidelines.
- A valid California identification card and original doctor's recommendation must be presented to staff each order.
- All medicine is non-transferable. Giving your medicine to another individual is not allowed, except in a patient-primary caregiver relationship. Violation will result in revocation of membership and may be reported to local authorities.
- Members may order medicine only for their use or in the event that they are a caregiver, only for their patient's use.
Call us at: (408) 930-0370