Ceremony Application

(360) 712-9039

info@sacredmedicinechurch.com

House of Dreams in a newly formed Church located in Washington State. We are not a "Traditional" Church and we are not Shaman from the Amazon. We are non - dogmatic and strive to provide a safe space for deep and profound healing with a sacrament that has been used for thousands of years. We blend tradition with new age philosophy. We believe we can intertwine the medicine into our lives in the Western world. It doesn't have to be an extreme lifestyle change.

Our ceremonies are lead by a highly trained and experience Medicine Facilitator. We We do not claim to be "Shamans", but are experienced in this realm and provide a safe healing space for our members, combining Ancient and Western views of healing.

Our medicine combines at least two natural plant medicines. One of them containing DMT, and the other, an MAOI inhib- itor which can create a physical, emotional, and spiritual experience. However, not all people are able to connect with the medicine as deeply at first. Sometimes we have blockages to the medicine, but even of you don't feel any sensations or see visuals, Mother Aya will still be healing you on a deeper level.

Here are the steps to follow if you would like to attend ceremony:

1 - DO YOUR RESEARCH. Please know what you are getting into here. Watch documentaries online, and research online and in books. Ayahuasca is not a "party drug". This is a religious sacrament that we take in order to connect deeper with the Divine within ourselves and the natural world. This medicine can produce very intense effects and cause "purging" in many different forms such as vommiting and diarrhea, or sometimes sweating, shaking, crying, laughing, feeling extreme temperatures, and seeing scary or unpleasant visuals. We consider this process to be how Mother Ayahuasca cleans/purifies our mind, body, and soul.

2- Please indicate your time frame on when you would like to attend by responding to this email.

3- Fill out the medical intake form. Please scan and email this form back with signature. If you do not have access to scan- ner, then respond back in the body of the email and we can have you sign the copy upon arrival to ceremony or bring copy with you.

3 - Start to mentally prepare. Maybe start to change lifestyle to live a bit more mindfully such as eating healthy, exercising, maybe preparing meal plans to follow for Aya diet. More fruit. More water. MUST BE OFF ALL medications for at least one month. Do not come into this with any expectations.

4- If you have questions or would like to speak with the facilitator, we can set up a phone call.

5 - Before being scheduled, there will be a mandatory 30 min phone call to go over any questions and details.

+*We hold small, intimate ceremonies with a max of 5 people. We provide all female, all male, and some co-ed ceremonies.

(360)712-9039 | info@sacredmedicinechurch.com

Event Location: Washington State

The ceremony with House of Dreams is primarily a spiritual undertaking and although personal growth can occur, the experience should not be seen nor is it designed to be a substitute for psychotherapy, psychiatric or other medical care. This ceremony is not appropriate for persons with certain medical conditions or for persons using certain medications. If you have any doubt or concerns about whether you should participate, consult with the organizer before attending. Please answer the following questions as completely and honestly as possible.

IMPORTANT FOR WOMEN: If you are expecting to be on your moon time during the ceremony we ask that you wait to attend until the two medicine times do not coincide. Please feel free to ask for more information about this.

Please be aware that the list of contraindicated substances includes but is not limited to SSRIs, SNRIs, pain medication, cold and sinus medication, decongestants, nasal sprays, hay fever medications, diet pills, heart medication, amphetamines, MDMA, and other drugs and substances. If you have been using any drugs, medical, over the counter, or otherwise, please advise the organizer to discuss this matter further.

I hereby confirm that I have read and understood the above information and have answered all the questions completely and honestly and have not withheld any information. My general health, as far as I am aware, is good.

I the undersigned hereby seek to participate in meditation with House of Dreams ~ Sacred Medicine Church. I understand the Church seeks to ensure the safety of all participants. In order to assist in this regard, I agree to complete the Confidential Medical History form provided. I am assured that the information provided will remain strictly confidential and will serve only as a guide in determining the appropriateness of my participation in the meditation and in meeting my needs before, during and after the ceremony. I have been informed of the nature of the medicine, the needed preparation, and the rules of the ceremony. I commit myself to stay in the circle until the end of the meditation and to respect the directives given by the organizers, helpers, and leader(s) of the ceremony.

I acknowledge that participation in sacred ceremony with House of Dreams ~ Sacred Medicine Church, may involve discomfort and unexpected physical, mental, or emotional upset. In signing this release document, I agree to waive all rights to seek or receive compensation in case of injury, loss, or damage. 

Participation in the sacred ceremony includes the ingest of an entheogen known as Ayahuasca. This sacrament is a natural tea made from plants that grow throughout the Amazon Basin in South America. I have been informed of the objectives of drinking this sacred medicine during ceremony and of its possible effects.

I choose to attend this work as a result of my research and interest in such ceremonies. I understand that my participation in this ceremony is entirely voluntary and I agree to remain at the ceremony to its completion. I accept the ceremony leaders and helpers make no claim or promise about the curing of illness of any kind, or about the nature of any spiritual experience which I understand is entirely personal.

I understand that my participation in the ceremony may be physically, mentally, emotionally, or spiritually demanding.  I understand that I may experience dizziness, nausea, or other physical upsets including vomiting and diarrhea. I accept full responsibility for anything that may occur including emotional disturbance, mental disorientation and any and all manifestations of physical, emotional and mental changes. I acknowledge that the risks and potential benefits of my participation have been explained to me and I freely choose to enter this process, accepting full responsibility for whatever may occur whether anticipated or unanticipated.  

I acknowledge that the proper dietary guidelines have been provided to me and I take full responsibility for adhering to these guidelines.

I acknowledge that, I have made all arrangements for transportation to and from the location of the ceremony, including appropriate transportation in the event that I may be physically or mentally exhausted and/or disoriented after the ritual.

I hereby knowingly and voluntarily assume the full risks of any physical or moral injury, damage or losses, either to myself or caused to others by me during the ceremony. I hereby waive the liability of and agree to hold harmless, House of Dreams ~ Sacred Medicine Church, and all the helpers, associates, employees, agents, staff, family successor, volunteers, and other participants. I further agree to defend and indemnify them from any claims, suits and demands. This agreement is binding upon myself, my spouse, parents, family, heirs, executors, administrators, agents, and assigns.

I HAVE READ, UNDERSTAND AND TAKEN THE TIME TO CONSIDER THIS WAIVER.