Xochipilli Mini Retreat – Mamay Ayahuasca Jungle Ceremonies

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1 Welcome

2 Price

3 People in your group

4 Participant Info

Phone *
Special Diet *
Diet Notes	Please share any allergies. We often serve rice, tortillas, eggs and white fish.
Is this your first time taking Ayahuasca? *
Have you taken any therapeutic approaches? If so, please share. *	Examples are: Hypnosis, tapping, other plants, meditation etc Enter none if you have not.
Medical Issues *	Enter "none" if you have no issues
Do you have a history of any physical, emotional or mental health conditions? If yes, please explain with detail, including treatment. *
Emergency Contact Info *	Please enter the name and phone number here, thank you.
Comments or Special Needs
Terms and Conditions *	I accept the terms and conditions.The event is 100% refundable for cancellation 60+ days before the event start date. The event is 50% refundable if cancelled 30-59 days before the start date. Also, we offer the option to reschedule within 4 months. The retreat host will contact you about payment of the remaining balance.
Email newsletter	Please send me the email newsletter
Payments do not include the cost of plant medicines. *	I understand that payments made through Retreat Guru do not include the cost of: plant medicine, psychedelics or similar products. There will be no additional charges for this retreat.Supplementary Products Exclusion: Participants acknowledge and agree that these Fees presented and payable pertain solely to Services and Offerings, and will not include the cost of any plant-medicines or similar products (collectively, "Supplementary Products") which may be provided, offered, or distributed by a Commercial User, or any other party, in connection with Services or Offerings. Retreat Guru shall bear no responsibility or liability in connection with any provision, offering, or distribution of Supplementary Products, and is not a party thereto. All capitalized terms used herein shall carry the same meaning as assigned to them in Retreat Guru's Terms of Service.

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