Private Ayahuasca Ceremonies in Southern California - Inquiry Form

1.Your Name(Required.)
2.Email Address(Required.)
3.Phone Number(Required.)
4.How many people are you planning on having in ceremony?(Required.)
5.How many ceremonies are you interested in having?(Required.)
6.I understand that each person who is planning on attending must complete a medical intake form.(Required.)
7.I understand that each person in attendance must complete a general liability waiver and informed consent.(Required.)
8.Please provide us with the dates that you are wanting to have ceremony. List on the order of your preference.(Required.)
9.What city are you wanting to have the ceremony in?(Required.)
10.Please describe the location to us, such as is this aa Airbnb property or private residence? Please note that we cannot conduct ceremonies in apartments or hotel rooms. Live music and sound are part of our ceremonies and are not ideal when sharing a wall with your neighbors. (Required.)
11.Payment and Refund Policy:

The cost for each private ceremony is $2,500 for 1 - 4 people, which includes 2 facilitators. Anymore than 4 people will result in an additional cost, totaling $3,500 per ceremony, as we will providing a 3rd facilitator. We can hold space for up to 6 people.

You are required to pay the entire amount in full, which is non refundable and non transferable. You can send payment to Zelle or Apple Pay 909-471-3248 with no additional fees. To pay by credit card we will send you an invoice with an additional 5% fee.
(Required.)