Blue Lotus Application Form

Blue Lotus Application Form
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Date of Birth*

MonthDayYear
Date
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?