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Sacred Secrets of The Andes Retreat Registration
Name as it appears on your passport
First name
*
Middle name
Last name
*
Passport Number
*
Email
*
Address
*
WhatsApp
Arrival date
*
Arrival time
Time
:
Hours
Minutes
AM
Flight number
Do you require pre or post retreat accommodation?
*
Pre
Post
Both
None
Please provide dates and budget for pre and post retreat accommodation.
Food Options
*
Meat
Vegetarian
Vegan
Gluten Free
Dairy Free
Other
Do you regularly participate in any of the following?
*
Alcohol
Cannabis
Recreational drugs
No
Other
If you answered yes to any of the above, please clarify how often and for how long.
*
Do you have travel insurance for this trip?
*
Yes
No
Not sure yet
What level hiking skills do you have?
*
Basic
Intermediate
Advanced
Other
Have you worked with plant medicines before?
*
Yes
No
Other
What is your intention for joining this retreat?
*
Emergency Contact
*
Emergency Contact Phone
*
Any other information you wish to share?
Submit
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