Ascension Adventures Application

Name

First NameLast Name

WhatsApp / Phone Number (Please include your int'l country code)

Email

example@example.com

Which retreat experience are you desiring to apply for? (Check all that apply)

Portal Of Liberation - Ayahuasca - ColombiaJourney to Remembrance - Psilocybin & 5-MeO-DMT - NetherlandsPrivate Retreat ImmersionOther

How did you hear about us? (Promo Code)

Please tell us about yourself and give us a greater understanding of your "Why" for applying for this experience and why now is the right time for you.

Please tell us about your personal development journey and any inner work that you have been a part of in the past. (Retreats, Healing modalities, Courses, etc)

What are any traumas or healing experiences you are seeking support on, as well as any physical symptoms or issues.

Have you had any plant medicine or psychedelic experiences in the past?

YesNo

If Yes, please explain your experience: What type of medicine, when, where?

Tell us about your desires and what you feel the most excited about in life. This could be what you consider your purpose, what is calling you forth to expand into, or lights up your soul.

Are you ready and willing for investing in yourself with the time, effort, energy, and financial commitment to dive into your healing, awakening and expansion to your Remembrance?

YesNo

What is your current financial position?

I have the financial resources to invest in myself now.I have access to financial resource to invest in myself right now.I don't have any financial resources at this time

Note: Upon hitting the Submit Button below, you will be redirected to a calendar link to schedule a 30 minute zoom call with one of our team members to discuss all the details of the retreat experience and answer any questions that you may have.

We look forward to connecting with you soon!

Ascension Adventure Retreat Application