Blue Lotus Application Form

Blue Lotus Application Form
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Time of Birth
Location of Birth
Current Location
How did you hear about the Blue Lotus Ceremony Experiance?
What draws you to the Blue Lotus Ceremony at this time?
Which month(s) are you interested in attending?
Have you worked with plant sacraments or ceremonial spaces before?
If yes, please share how many times and what plant medicines you worked with?
Are you currently taking any medications or have any mental/physical health conditions we should be aware of to ensure your safety?
Are you open to being contacted for a brief connection call to help prepare you?
What Happens Next?

Once submitted, we will review your application and respond with the next steps, including available dates, preparation guidelines, and contribution details.

Thank you for honoring this sacred path.
Should be Empty:

What Happens Next?