Sacred Plant Ceremony Form

I understand that some plant medicines categorize as purgatives and can disrupt and alter your hormonal balance.
I understand that plant medicine is not recommended for the faint heart and can be unhealthy for patients on pharmaceuticals.
Kambô can be served to sever ties and break connection with everything that is not you in nature.
Because some of our ceremonies involve the ingestion/utilization of sacred plants, we carefully screen each guest for their safety prior to attending a tour. All herbal supplements, natural medicines, and medications (prescription and over-the-counter) must be disclosed and subsequently approved for use by us. All herbal supplements, natural medicines, and medications (prescription and over-the-counter) cannot be taken during the course without the expressed permission of our data representative. You hereby agree that all information you provide in the application is correct and current and that you have disclosed all physical and psychological conditions as well as all herbal supplements, natural medicines and medications (prescription and over-the-counter) that you are taking. Its for your safety. In some cases, you will be contacted personally by me to ensure that you are prepared for the experience. We are not a medical facility and we are not doctors, psychologists, or psychiatrists. We do not diagnose, cure, or treat disease or illnesses. Instead, we function as guides, teachers and door openers that offer ceremony for the purpose of your spiritual communion.
Our ceremonies involve the ingestion of sacred plants, there are certain dietary and behavioral restrictions that must be followed. You will be advised of these restrictions when you arrive. Each specific set of restrictions should be followed according to the corresponding ceremony. The amount of sweets that can be consumed due to the use of sacred plants is limited. Consumption of alcohol and drugs are not allowed at any time participating in our ceremonies. Consumption of shellfish or pork is not recommended during the entire duration and for 30 days after your last shamanic ceremony with sacred plants. You must also abstain from alcohol consumption and the use of chemical drugs for seven days after your last ingestion of sacred plants. There is to be no sexual activity whatsoever between guests and/or staff. This includes married couples. This also includes masturbation. The environment demands abstinence from all sexual activity. Should you develop a sexual or romantic interest in another person, delay any physical displays or expressions of it until the retreat is over. We are not attempting to create a moral or philosophical boundary but preventing the potentially dangerous crossing of energetic fields that can result from sexual or romantic behavior while engaged in sacred shamanic ceremonies.
For your safety our shamans have a “no medications/vitamins/supplements policy” with the exception of birth control pills. Medical studies have shown that mixing medications with plant medicine can be dangerous. We are not licensed to give advice on prescription medications. If you are currently taking medications, please consult with your doctor before discontinuing any medications. If your doctor approves discontinuing your medications and has guided you on the weaning process then we require that most medications need to be fully stopped at least one month before the workshop begins so that your physiology can find safe balance without it. This stability period could be extended up to six months depending on the combinations and types of medications being taken.
By checking this checkbox and typing my details in the fields above, I attest that I have read and understand all of the above written medical information and have openly disclosed all requested health and medical facts. I attest that the information provided above is true and complete, to the best of my knowledge. I understand that falsifying or omitting any relevant information may be dangerous and grounds for denying my attendance at this and any future ceremony for which I am applying, with or without a refund, at the sole discretion of me, I hereby waive, release and hold no harm from any and all liability or responsibility for all impact, any injuries and/or damages or claims which may occur in the event of attending a ceremony.

Thank you for cooperating! We are with you all the way so don’t hold back your questions. Please put some time into preparation before your retreat to get the most out of your meeting with plant medicine as possible. Preparation details can be found on this website and will be sent to you days after submission of this online form. We look very much forward to assist you on your journey.

Best regards, Wesha Kea