Pilgrim Details
Full name as shown on your Passport
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Passport Number
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Passport Expiry Date
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Nationality
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Date Of Birth
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Month
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Day
Year
Date
Email
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example@example.com
Your WhatsApp number (international format, ie. +61400 000 000)
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Cell / Mobile Phone Number (if it's different from above)
Emergency Contact Name & Relationship (i.e. Jon Smith, husband)
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Emergency Contact Phone Number (international format, ie. +61400 000 000)
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Flight Arrival Date, Time, Airline & Flight Number (so that we can arrange for someone to pick you up from the airport)
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Name and address of your Hotel
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Flight Departure Date, Time, Airline & Flight Number (so that we can arrange your airport transfer on the final day)
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How did you hear about us? (Name of person who referred you)
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Do you agree that if you are experiencing any COVID or cold/flu type symptoms, you will let us know and, out of respect for others on our journey, you will postpone your trip?
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Have you worked with grandfather or any other plant medicines before?
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Yes
No
If YES, which plant medicine and what was your experience (very briefly)
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Are you experiencing any fear or doubt?
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Are you dealing with any addictions or mental illness? If YES, please elaborate (It is extremely important that you share this with us honestly, as this can affect your process with the medicine)
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Are you on any medications? If YES, please elaborate
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Have you had any major Surgery? If YES, please elaborate
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Are you dealing with any major traumas?
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Do you have any medical conditions we should be aware of, including diabetes or Low /High blood pressure?
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What do you hope to receive from this experience?
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Please confirm here the date of the Peru Pilgrimage experience that you are booking?
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When hiking in the Andes, you will experience rugged terrain, the trails are not always perfect (although safe) and elevation is often very high. Do you feel ready for this adventure?? We can arrange horses for you too if need be, just let us know
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Our accommodation is extremely comfortable and quite luxurious, but it is not 5 Star. Sometimes we will be staying in Communities (for a true local experience) and may camp a night or two. Are you ok with this?
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The accommodation is either Shared Room, Single Room (for USD$1777 extra), or Double Room if you're travelling with your partner. Please select:
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Shared Room
Single Room (I agree to the extra USD$1777)
Double Room
If you selected Twin Share, are you ok with sharing a room with anyone, or would you prefer to share only with someone of the same sex?
If you selected Double Room, please write the name of your partner so we can match up your booking and allocate the room
In the Andes, people interact with Spirituality differently. They LOVE to CELEBRATE. It has been a part of their Culture for eons. As we are travelling with LOCAL people, not western tour guides, it is not unusual for you to see your Paco’s (Shamans) having a Cerveza, Pisco or Chicha at the end of the day. Are you ok with this?
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Also, traditionally they have meat in their diets (although all dietary requirements are lovingly and easily catered for). It is what has helped them survive and thrive as a people in the harsh Mountain climate. They have a very different relationship to their animals than in the West. Are you comfortable with this?
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Can you please advise us of any dietary requirements you may have
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Are you feeling ready for this experience?
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Submit
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