New Ceremony Application

Please tell us if you have any disease, pathological or functional problem not considered here.
All the information provided will be kept private.
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IMPORTANT By clicking the SEND FORM button on the Application Form you agree to the following terms :
I understand that shamanic work may include the use of traditional healing plants.

I agree that I always have a choice whether or not to parti-cipate, and I agree to take full responsibility for the choices I make involving this work, both during and after the event.

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To the best of my knowledge, I am in good physical condition and I am not aware of any physical, physiological, or psychological infirmity which would place me at risk to participate in any way within the ceremony activities.

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I take full responsibility for my own belongings and safe transportation to and from the ceremony/workshop.

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I understand that the facilitators reserve the right to deny my participation if they deem that it would be unsafe for me, or for others, or for any other important reason.

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I agree to listen and follow the instructions given by the facili-tators.

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I take full responsibility for any damage that I may cause to the facility that is used for the ceremony.

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To maintain the safety, trust and respect for all participants, I agree to hold this work confidential. I will not reveal to anyone the identity of those who are participating in the event. This includes maintaining confiden-tiality for all facilitators, helpers, shamans or healers who are also participating in the ceremony.
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I hereby RELEASE, WAIVE, DISCHARGE AND COMMIT NOT TO SUE the event leader, organizers and/or participants for any and all liabilities, claims, demands arising from or related to the event.
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I agree to participate with the purest intention of heart, promo-ting the health and well-being of all participants.
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In signing this release (Clicking the Submit button), I acknow-ledge and represent that I have read and understand the above and sign voluntarily; I excuse this release for full, ade-quate and complete release of liability.

Plant Spirit Ceremony Application

"*" indicates required fields

Today's Date (DD-MM-YYY)

Date of Ceremony (DD-MM-YYYY) you wish to partake - Required*

Check Ceremony Calendar for updates: https://maestralaynah.com/peruvian-medicine/ceremony-calendar/

Personal Data

Name - Required*

First Name Last Name

Address*

Street Address City State/Prov/ Postal Code

Best Phone # to reach you - Required*

Format (xxx) xxx-xxxx

Best email address to reach you - Required*

Enter Email Confirm Email

Birth date (DD-MM-YYYY)- Required*

You must be of legal age to participate in these ceremonies or retreats. However, with signed parental consent, each applications is received with kind loving heart. Many young people are feeling called to their divine nature.

Occupation

Emergency Contact

Emergency Contact - Required*

You must provide the name of you emergency contact. It cannot be the same name or telephone number as yourself.

First Name Last Name

Emergency Contact Email - Required*

Enter Email Confirm Email

Emergency Contact Phone # - Required*

Format: (xxx) xxx-xxxx

Doctor's Name

First Name Last Name

Doctor's Contact Phone #

Please enter 555-555-5555 if you do not have a physician

Share About Your Experiences

Do you have experience with psychedelic/entheogenic plant spirit medicine? (like Ayahuasca, San Pedro, Mushroom) - Required*

How many years of experience do you have with spiritual and/or personal development? - Required*

What is your experience with meditation, dancing and body work? - Required*

What would you like to look into/release or bring into balance with Grandmother medicine? - Required*

What is your intention for your healing process with Grandmother Medicine? - Required*

“It is important to formulate an intention when journeying with Plant Spirit Medicine as a point of focus for your preparation for the journey. But it's also important to distinguish between intention and expectations, because the way to your intention is, most likely, not through achieving your expectations, because your expectations are largely part of your consciousness and so much of what Ayahuasca is, relates to your subconscious and that which is even greater or outside of us, which your consciousness knows nothing about. In fact, you can achieve your intention, even though it does not feel as if you have, because what you experienced was part of some necessary preparatory healing or because you received a precise but indirect answer”. A good intention is like having a map for reaching the wisdom that will help you in your healing journey. Please be specific with a realistic Intention. You do not get into your car and drive without a destination in mind. Intention is the direction of your journey.

Please describe your medical history, past and present conditions. - Required*

Explain any body aches and pains, PTSD, anxiety, childhood trauma, any suspected abuse or anything that is causing you to feel less then.

Are you taking any of the following groups of medications? - Required*

Many medications prescribed by your doctor maybe incompatible with these ceremonies.

Do you have a heart condition, or have you ever had an ECG test to screen for this? - Required*

Do you have allergies or dietary requirements? - Required*

What spiritual practices if any, do you engage in? - Required*

What daily practice do you do that anchors you soul into form?

Commitment to Preparation

I agree to follow and commit to the Pre & Post diet guidelines found on this website and I certify that I have answered truthfully all questions. - Required*

Dietary guidelines found hereL https://maestralaynah.com/peruvian-medicine/preparation-and-after-care/diet-guidelines/ Medical guidelines found here: https://maestralaynah.com/peruvian-medicine/preparation-and-after-care/medical-guidelines/

YES

If you were referred by someone, please let us know

Any other information you would like to convey that we may hot have asked?

Next Steps - Check your Spam/Junk Folders for emails

Application Supplemental Notes - Required*

If you did not receive a confirmation email that your form has been sent, it is more and likely that you missed one item in the form. This process is not immediate and can take up to a week or more. Please DO NOT make travel arrangements until you have been approved. *** THERE ARE NO REFUNDS ***

I understand that I need to book an online Zoom Interview next to complete my application. A $55 Non Refundable Fee is applicable (part of total cost)

Book Online Interview here: https://laynahlafond.setmore.com/services/5c0a6964-f07c-4d0f-96af-ad46626643e0

I have read the Medical Guidelines for any contra indicated medications

I understand that once I commit to a ceremony, there is NO REFUNDS

Check your spam/junk folder for emails from ceremonies@maestralaynah.com or maestralaynah@gmail.com

Consent to Privacy

It is of the highest calling to protect these plants spirit medicines and keep these powerful plant teachers in the solace of your heart. These spiritual practice and sacredness of rites, rituals and ceremonies is often missing in people's lives causing extreme soul disconnection. I entrust you with this protection, use wise wisdom in whom you feel guided to share this path with. If you cannot be vulnerable with your friends over a cup of coffee, then you will not feel safe in ceremonies with them. Best to let them be.

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