Rebirth Journey with Ayahuasca & Temazcal

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Retreat Application

Warm greetings! Thank you for taking the first step toward joining our sacred ceremonies. This application marks the beginning of your healing journey, as we believe the process starts the moment you set your intentions and share them with us.

Sitting with Ayahuasca is a profound and sacred experience that requires careful preparation. Our ceremonies are designed for those who approach this work with humility, respect, and a deep reverence for the sacredness of these gatherings and the plant medicines. This transformational journey calls for individuals who are open to personal growth and the healing spirit of this work.

Participation in these ceremonies may involve intense emotional and physical releases. For your safety, we carefully screen each participant, as certain medical conditions or medications may make this experience unsuitable.

We kindly ask that you answer the following questions with honesty and thoroughness. Transparency about your health history, past experiences, or any challenges—including prior substance use or addiction—will not necessarily disqualify you but will help us ensure that this is the right path for you at this time. Our goal is to provide a safe, supportive, and healing environment or guide you to a modality better suited for your needs.

All information you provide will remain strictly confidential.

Important Notes:

After submitting your application, you will receive an email with the next steps. If you do not receive confirmation within 2 days, please contact us at service@chi.university.

Thank you for trusting us to guide you on this sacred journey. We look forward to supporting you in your healing and transformation.

* These fields are required

1 Primary Contact

2 Select your dates

3 Program Charge

All pricing is expressed in US Dollars and includes lodging, meals at the center, integration workshops. Optionally you have the option of + "Round-Trip Airport Transfer" our goal here is to make your travel effortless with our comprehensive airport transfer service. Our team will greet you upon arrival, assist with luggage, and ensure a smooth journey to the retreat. At the end of your stay, we’ll coordinate a seamless drop-off back to the airport. Relax and enjoy the journey – we’ve got everything covered!

Select a price.

$777.00 – Rebirth Journey with Ayahuasca & Temazcal

Number of Guests:

$1,111.00 – + Round-Trip Airport Transfer

Number of Guests:

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4 People in your group

Guest 1		First Name* Last Name* Email* Gender*
Guest 1		First Name* Last Name* Email* Gender*

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5 Complete Your Registration

Participant Informed Consent Disclosure at bottom.

Address
Address 2
City
State/Prov.
Zip/Postal
Country
Comments or Special Needs
Gender *	Your answer will support gender-based shared room assignment, if applicable. If you identify as trans, non-binary, neutral and are sharing a room, please select a gender that you are most comfortable sharing a room with.
Birth Date
Requested Roommate
Diet *
Diet Notes
Emergency Contact Info
Medical Issues *	Enter "none" if you have no issues
How did you hear about us?
Terms and Conditions *	I accept the terms and conditions.Please read the terms and conditions
Security check *	Type the text shown:
Refund & Cancellation Policy *	Refund & Cancellation Policy The event is 100% refundable if cancelled 30+ days before the event start date. The event is 50% refundable if cancelled 15-29 days before the start date. There's no refund for cancellation 0-14 days before an event.
I acknowledge the potential risks	I acknowledge the potential risks of these practices and affirm that I have received satisfactory answers to any questions. I release the organization and its practitioners from liability for any adverse effects related to my participation. I confirm that I am a competent adult, acting solely on my own behalf.
Discount code
Payments do not include the cost of plant medicines. *	I understand that payments made through Retreat Guru do not include the cost of: plant medicine, psychedelics or similar products. There will be no additional charges for this retreat.Supplementary Products Exclusion: Participants acknowledge and agree that these Fees presented and payable pertain solely to Services and Offerings, and will not include the cost of any plant-medicines or similar products (collectively, "Supplementary Products") which may be provided, offered, or distributed by a Commercial User, or any other party, in connection with Services or Offerings. Retreat Guru shall bear no responsibility or liability in connection with any provision, offering, or distribution of Supplementary Products, and is not a party thereto. All capitalized terms used herein shall carry the same meaning as assigned to them in Retreat Guru's Terms of Service.

Participant Informed Consent, Disclosure, and Disclaimer Shamanic Ceremonies and Responsibility By attending this retreat, I understand that the organization and its practitioners do not claim to treat or cure any illness or disease. The Shamanic Ceremonies offered are complementary to, and not a substitute for, state-licensed medical services. These ceremonies, rooted in traditional and indigenous healing principles, are intended to support balance and wellness within body, mind, and spirit, but they are not medical diagnostic procedures. Scope of Services Practitioners may engage in traditional and indigenous healing practices, which may include discussions on lifestyle, nutrition, and spiritual wellness. Certain practices may involve touch, natural plants, physical movements, and ceremonial sacraments. It is recommended that participants follow a strict plant-based diet and abstain from alcohol for at least 2–3 weeks prior to the retreat to enhance results and increase receptivity to the experience.. I agree to continue all prescribed medications and treatments unless directed otherwise by the prescribing medical provider. Ayahuasca and Purging The ayahuasca ceremonies may involve physical purging, which is considered a natural and integral part of the experience. Facilities, staff, and practitioners will be on-site to monitor participants and hold space to ensure maximum comfort and safety throughout the ceremony. Assumption of Risk and Acknowledgment of Rights I acknowledge the potential risks of these practices and affirm that I have received satisfactory answers to any questions. I release the organization and its practitioners from liability for any adverse effects related to my participation. I confirm that I am a competent adult, acting solely on my own behalf. Ninth Amendment Declaration and Constructive Notice Pursuant to the Ninth Amendment to the U.S. Constitution, I retain my right to freedom of choice in health care, including the right to choose my dietary and wellness practices. Any interference with these rights may be considered a violation of my civil and constitutional rights under Title 42, U.S.C. § 1983 and Title 18, U.S.C. § 241.

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25% Deposit	$0
	$0 next payment date * last payment amount will be $0

Rebirth Journey with Ayahuasca & Temazcal

Retreat Application

1 Primary Contact

2 Select your dates

3 Program Charge

4 People in your group

5 Complete Your Registration

6 Payment