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If you've already participated in a previous program, login to populate this form or to use any existing program credit. You may also continue without logging in.

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Blessings! Once you've submitted your application below, you will be taken to our booking calendar to book your phone call with us. We take this time together to hear about your intentions and to help you get the most out of this retreat. Also, to ensure there is a right fit, for your safety and all our guests. Enjoy completing the application and we look forward to speaking with you soon!

Participant Info

If you have completed a form with us in the past, please enter the same email address you previously used
Please include your country code +
Please enter full name & phone number
If so, please elaborate.
If so please outline what, how much and how often (please be as detailed as possible here)
This includes psychological as well as physical ailments
Please note that ceremonies should not be seen nor are they designed as a substitute for psychiatric or other medical care.
By checking the above you acknowledge that you have read and agree to our
Ayahuasca Healings Retreats - Terms and Conditions