GreenRock Dispensary Application

Dispensary Information





Applicant Information




Non-expired Doctor's Recommendation:

Valid Photo ID:

WHAT IS A SELLER'S PERMIT?

If you sell medical cannabis, the law requires you to register with the Board of Equalization (BOE) for a seller’s permit. You can register for a seller’s permit on the BOE website. There is no cost to obtain a seller’s permit. Moreover, you are not required to disclose the type of product you sell. You can get additional information on Sales Tax and Registration for Medical Marijuana Sellers here. Click below to register with the BOE now.

I agree to the GRB Membership Agreement. I acknowledge that as a patient member, I shall have the right to access all benefits of the Collective but shall not have those rights set forth in Section 5056(a) of the California Corporations Code. I further acknowledge that the Collective reserves the right to refuse service and/or membership to anyone, at any time, at its discretion, and may terminate membership at its discretion.

As a qualified patient protected by California Law, Health & Safety Code §11362.5 and §11362.7, et seq., and, in conjunction with California Health & Safety Code § 11362.775, you are required to read and agree to the following statements to become a member of GREENROCK BOTANICALS, INC.

I, hereby declare and agree as follows:

Article 1. I am a qualified patient entitled to the protection of California Health and Safety Code section 11362.5, et seq., because my physician has recommended/approved my use of cannabis for medical purposes.

Article 2. I agree and understand that all medicine obtained is for medical use only and may not be diverted for non-medical use or for use by a non-member of the Collective. I understand that it is a violation of this agreement and of California law to sell or divert my medicine in any way and for any reason to any other person and a violation of this section will result in immediate revocation of my membership in the Collective.

Article 3. As a member of the Collective, I recognize that there are risks inherent in the use of medical cannabis. While the Collective takes every reasonable precaution to assure the quality, purity and effectiveness of the medical cannabis, the Collective makes no warranties or representations as to the quality, purity and effectiveness of the medical cannabis. I understand that the Collective 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 Collective when used by itself or with other medicine.

Article 4. I hereby release, waive and discharge the Collective, including its officers, agents, employees, managers, independent contractors, parent organizations, subsidiaries, affiliates and other personnel (“Releasees”) from, and agree and covenant not to sue Releasees 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 the negligence of Releasees or otherwise, resulting from or in any way associated with my presence on the premises Collective’s facilities, amenities, or services.

Article 5. I hereby authorize the release of my medical information concerning my diagnosis, condition or prognosis to the Collective and its authorized representatives for purposes of verifying the validity of my medical recommendation and the valid operation of the Collective pursuant to the Compassionate Use Act and Medical Marijuana Program Act.

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