Booking form

Participant Information

Full Name * Email Address * Phone (with country code) * Date of Birth * Gender *

Male Female Other / Prefer not to say

Country of Residence *

Retreat Selection

Retreat you are interested in joining *

Ayahuasca-Specific Questions

Have you ever had experience with Ayahuasca before? *

Yes No

Please share your experience (when, where, how many times, with whom)

Are you currently taking any medications or supplements? *

Yes No

Please specify (include dosage and frequency)

Do you have any allergies or special dietary requirements? *

Yes No

Please specify

What do you hope to get from this Ayahuasca retreat? *

Master Plant Diet-Specific Questions

What type of plant diet are you seeking, and what is your intention for this process? * Have you ever participated in Master Plant Diets before? *

Yes No

Please share your experience (when, where, how many times, which plants)

Are you currently taking any medications or supplements? *

Yes No

Please specify (include dosage and frequency)

Do you have any allergies or special dietary requirements? *

Yes No

Please specify

I have read and accept the Terms & Conditions and accept full personal responsibility for my participation, releasing Amazon Jungle Retreat and Tahuayo Amazon Journeys S.A.C from any legal liability.

Join us under the moonlit selva near Tamshiyacu Tahuayo National Reserve, in sacred harmony with Jerusalén, to awaken your soul’s divine truth.

Connect with us

Sacred plant medicine retreats in the heart of the Peruvian Amazon, near Tamshiyacu Tahuayo Reserve. Guided by Shipibo and Achuar wisdom in collaboration with the Jerusalén community.

Contact

Email:
info@amazonjungleretreat.com
WhatsApp:
info@amazonjungleretreat.com

Information

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Environmental Responsibility