Interest Form

Welcome.

If you'd like to learn more about our retreats or group experiences, please submit this form and schedule your consultation.

Our three day retreats begin at 1pm on Day 1 and end at 12pm on the Day 3. They include local, organic meals, lodging.

Name

Phone Number

Date of Birth

Age & Health Verification

I am over 21 years old

I have not taken the drug lithium in the last 30 days.

I have not been diagnosed with schizophrenia disorder.

I do not have any significant cardiac-related health issues.

I am not currently having thoughts of causing harm to myself or others.

Please tell us a little about your background what brings you to be interested in this. Please share about any previous experience with psychedelics.

Which date(s) could potentially work for you?

June 28-30 retreat $2500

August 2-4 retreat $2500

October retreat $2500

Private retreat

Do you have any allergies or dietary restrictions?

Please share any questions or comments that are on your mind.