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New Member Application:  For CannaThrive

Pursuant to California Health and Safety Code § 11362.775

I __________________________________________________,  hereby certify that I am a  qualified patient suffering from serious medical conditions and have obtained recommendations or approvals from licensed physicians in the State of California to use medical cannabis (marijuana) to treat our medical conditions. Copies of our recommendations may be attached hereto.

As a qualified medical marijuana patient under California law, I choose to associate collectively or cooperatively with CannaThrive, a non-profit corporation to cultivate, buy or sell marijuana for medical purposes.  All members of our medical marijuana collective will contribute labor, funds, or materials, and all will receive medicine.  We formed this collective in accordance with California Health and Safety Code § 11362.775, which states:

“Qualified patients, persons with valid identification cards, and the designated primary caregivers of qualified patients and persons with identification cards, who associate within the State of California in order collectively or cooperatively to cultivate marijuana for medical purposes, shall not solely on the basis of that fact be subject to state criminal sanctions under Section 11357, 11358, 11359, 11360, 11366, 11366.5, or 11570.”

You agree under the grounds of perjury that you and not a member of any law enforcement agency.

This agreement shall be in effect as of (DATE)      ______________________.

_____________________________       :________________________________________

Patient Name (print clearly)                                   Patient Signature


Cell phone_____________________        email____________________________________

How did you find us?  _________________________________________________________


  1. Please print this page , complete then scan page and email to , or
  2. Give this completed copy along with a copy of your valid CA ID and valid doctor’s recommendation to your representative.
  3. You may also text a copy of your information to 559-513-9070, for verification.
  4. Sign yourself up at