Transformative Ayahuasca Retreats: Book Your Spiritual Journey Now for Healing and Self-Discovery

BOOK A HEALING CEREMONY.

Please fill out the following form to make a reservation. Your information is kept confidential and will only be used for booking purposes.

Personal Information:

Name

First Name

Last Name

Gender

Date of Birth

YYYY

E-Mail-Address

Mobile

Country

(###)

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Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Health Information:

Medical History

Please provide details of any pre-existing medical conditions, allergies, or medications you are currently taking.

Mental Health History

Have you ever been diagnosed with a mental health disorder? If yes, please provide details.

Ayahuasca Experience:

Previous Ayahuasca Experience

Have you experienced Ayahuasca before?

Yes

Expectations and Intentions

Briefly describe your expectations and intentions for participating in the Ayahuasca retreat.

Logistics:

Preferred Retreat Date

Additional Services

Feel the call to join our Kambo ceremony? No need to commit in advance – simply let us know upon your arrival

Kambo Ceremony 2h (non-binding)

Accommodation Preferences

Additional Information

Message

Please inform us of any dietary restrictions or preferences.

Acknowledgment and Agreement:

Liability Waiver

Participants will be required to sign a liability waiver acknowledging the risks and responsibilities associated with the Ayahuasca retreat.

I understand

Code of Conduct

Participants will be expected to adhere to a code of conduct during the retreat. Are you willing to comply with the guidelines provided?

Yes, I do

Terms and Conditions

I have read and agree to the terms and conditions of the booking.

I agree

Voucher Code

Please review your information before submitting the form. By clicking "Submit," you confirm that all details are accurate.