Trip to jungle

Ayahuasca Ceremony - Registration form

7 days program - 3 Ayahusca ceremonies

Please, fill out the form

What will happen? After filling in the application form, please wait for the request to pay the deposit. As soon as I have reviewed the data and information you have submitted, I will contact you via email. You will receive instructions to pay a deposit of $225.

This deposit serves as a booking fee and will be deducted from the total price of the retreat.

The rest of the payment is to be paid in cash on the first day of the retreat.

Personal Information

Read our policies:

"No supplements, no medication": This retreat involves the consumption of plants that may be contraindicated with certain medications or health conditions. Prior to attending the retreat, we carefully screen each guest for their safety. All herbal supplements, natural remedies, and medications taken within 30 days before and during the retreat must be disclosed to Amayas prior to the start of the retreat. All herbal supplements, natural remedies, and medications (prescription and over-the-counter) cannot be taken during the retreat without explicit written consent from Amayas. You agree that all information provided in the application is accurate and current, and that you have disclosed all physical and mental conditions as well as any herbal supplements, natural remedies, and medications you are taking.
By checking the box and entering my name in the field below, I confirm that I have read and understood all the medical information provided above, and that I have openly disclosed all required health and medical facts. I also confirm that I am of sound mind and agree to the rules of the Amayas retreat. Potvrzuji, že výše uvedené informace jsou podle mého nejlepšího vědomí pravdivé a úplné. Beru na vědomí, že falšování nebo vynechání jakýchkoli relevantních informací může být důvodem k odmítnutí mé účasti na retreatu, o který se ucházím, s vrácením nebo bez vrácení peněz, podle výhradního uvážení Amayas. Tímto také prohlašuji, že beru na vědomí, že Amayas nemůže za žádných okolností a z jakéhokoliv důvodu nést odpovědnost za jakákoliv zranění či škody, ke kterým může v průběhu retreatu dojít. Beru na vědomí, že Amays není zdravotnické zařízení a jeho majitelé, zaměstnanci a zástupci nepraktikují západní medicínu a nejsou licencovanými lékaři.*

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