Application Onanya Joni Application Onanya Joni Data protection The information provided in this form is strictly confidential and will be used solely for the purpose of processing your request. We are committed to ensuring the highest standards of data protection and confidentiality in accordance with applicable data protection laws. Your data will not be shared with third parties without your explicit consent, unless required by law. By submitting this form, you agree to the use of your information as described above. Should you have any concerns regarding data privacy, please contact us directly. * I understand and wish to proceed Personal contacts Full Name * Age * years old Email * Phone Address Check the options you’re interested in Retreat Trip Diet Retreat details What are the dates you’re interested in? * Intention for retreat Trip Details Choose the available dates * Peru – Chavin March 30 – April 7 2025 Peru – Tarapoto February 26 – March 5 2026 Peru – Chavin April 20 – 28 2026 State of mind Brief history, psychological, spiritual and physical state at the present Any disease or interaction that should be considered before joining the retreat? * No, nothing to report Anti depressants Heart problems Any drug you’re taking on a regular basis Marijuana or Cannabis Psylocibine OtherOther Read the section Health Concerns Important information Marijuana or Cannabis use can interfere with the effect of master plants How long have you been smoking? I’ve been smoking for How long have you been smoking? Day(s)Week(s)Month(s)Year(s) How often do you smoke? I smokejoints How often per DayWeekMonthYear Important information about Psylocibine stop 1 month prior Please describe the anti depressants you are taking Please describe the heart problems announced Please describe the drugs you’re taking at this moment Have you taken part in ceremonies before? * Yes No Please describe your ceremony experience and with whom? Have you done master plant diets? * Yes No Which plants, when, with whom? Have you ever be committed to a psychiatric hospital? * Yes No When did it occured? It was When did it occured? DayWeekMonthYear ago How long did it last? For How long did it last? DayWeekMonthYear Any suicide attempt? * Yes No Please tell when your last suicide attempt occured It was Please tell when your last suicide attempt occured DayWeekMonthYear ago For retreats and diets Check that you can handle the retreat’s requirements * I will not leave the room until the end of the ceremony I am aware that I will spend some time alone in my room or cabin and will not walk around I will not use my phone and will leave it to the organizers I will not bring any products with a strong smell (toothpaste, perfume, etc) to my room I will not bring candles, cigarettes, tobacco, personal shrines, tarot cards, dead animals or skins to my lodging I will not interact with other participants once the diet starts At the end, I will refrain from giving hugs or kisses to other participants I will practice no sports at all during the retreat I will not mix other traditions or energetic practices in this shamanic retreat SUBMIT APPLICATION If you are human, leave this field blank.
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