Contact Information

Name *

Last Name: *

Age *

Nationality *

Email address *

Phone Number *

Social Media Accounts *

Emergency Contact *

Context Information

What's your intention to participate in our activities? *

Have you participated in spiritual retreats before? *

Yes

How was your experience? *

Have you consumed any type of psychoactive before? *

Yes

What type of psychoactive have you consumed? *

Mention, if necessary, your medical history or any physical, emotional, mental or spiritual condition *

Are you corrently taking any type of medication? *

Yes

Do you have allergies or any dietary restrictions? *

Yes

Biography:

Please include a text document with all events that have marked you in your life, also short, medium and long life goals and all pertinent information you think could help us serve you better in your process.

Choose File

Reservation Information

Center *

Duration *

Details *

Arrival date *

Departure date *

Payment and Policies

Do you grant SachaRuna the rights to use name, image and diverse media that might be capture during the retreat? *

Yes

Do you accept our policy detailed down below?
I understand that Sacha Runa is a community of Shaman's that work with love, devotion and surrender to help people to live in communion with nature.
I understand that Sacha Runa is not responsible of my wellbeing if I so choose to leave the Healing Center without permission, and that by doing so I agree to cancel my stay without reimbursement.
I understand that the cancelation policy is that of 100% reimbursement one month before, that of 50% one week before and that of 0% later than that.
I understand that consumption of drugs, but particularly SSRI antidepressants, antipsychotics based on lithium and monoamine oxidase inhibitors may ban my participation in the shamanic activities of SachaRuna.
By agreeing this document, I accept all the above and state that I have read freely and agreed this document without any coercion whatsoever.

Yes

Payment:

After making the payment to the link we provided, please upload a screenshot of the transfer.

Choose File

Thank you for your registration, it has been sent. We'll get back to you shortly

There was an error trying to send your Form. Please try again.

Privacy Policy:

When you submit your data via this form & use our services, you’re trusting us with your information.

We understand this is a big responsibility and will work hard to protect your information.

Please be assured that we consider all the information you share with us totally private and confidential.

At no point will we share, rent or sell your personal information without your consent.