Phone/ Whatsapp Number *
Gender *	We only ask this question for rooming assignment purposes.
Are you pregnant?
Birth Date
Emergency Contact Name & Information *
Emergency Contact Disclosure *	I give permission for my personal health information to be disclosed to my Emergency Contact or Medical Personnel.
Medical Diagnoses *	Please list all diagnosed medical conditions
Have you experienced any of the following:	Fainting or Lightheadedness Severe Anxiety or Panic Attacks Hallucinations or Psychosis Claustrophobia Suicidal Ideation or Attempts Substance Abuse or Addiction These questions help our staff provide you with the best support during your retreat
Medications *	Please list all prescriptions and over the counter supplements you are currently taking
Diet *
Allergies *	Please list any food, medication, pollen, chemical, mold, animal hair, etc allergies
Comments or Special Needs
Arriving Flight Date
Arriving Flight Time
Arriving Flight Number
Departing Flight Date
Departing Flight Time
Departing Flight Number
Do you have experience with plant medicine?
How was your experience with plant medicine
How did you hear about us?

Terms and Conditions *	I have read the terms and conditions and agree to the release of liabilityPlease read the terms and conditions
Covid Liability Waiver *	I accept and agree to the Covid Liability WaiverThis CONSENT must be READ in full and acknowledged by the PATIENT who is opting of their own volition to continue their retreat at Mexisoul Retreats despite the National Pandemic Emergency. As part of being in any CLINICAL healing environment, PATIENTS may be inadvertently EXPOSED to a greater risk of the Coronavirus (COVID-19) despite our best attempts at physical distancing and heavy sanitation procedures. Mexisoul Retreats places the health and safety of our guests at the forefront and is, therefore, neither insisting nor recommending that guests CONTINUE with care based on this unprecedented COVID-19 pandemic. Guests who choose to continue acknowledge that they are fully appreciative of the potential health risks of doing so and ACCEPT any RISKS themselves and agree to NOT hold our practice liable in any way from our good faith efforts and care being offered during this crisis. Furthermore, guests opting to continue in the current state of affairs UNDERSTAND and ACKNOWLEDGE that they forever RELEASE and DISCHARGE Mexisoul Retreats and staff from any and all liability that is attributable to or related to the Coronavirus or any claims of contracting the Coronavirus as a result of receiving care from Mexisoul Retreats.
Drug Interactions *	I have read the Drug Interaction information and agree to the policyI will discontinue all use of alcohol, marijuana, recreational/street drugs and non-prescribed pharmaceuticals at least 7 days prior to attending Mexisoul retreats and coming to the Finca el Pendulo. *I understand that many street and recreational drugs are strongly contraindicated with Ayahuasca and can be very dangerous or potentially fatal when combined.
Refund Policy *	I accept and agree to the Refund PolicyRefund Policy I understand that a minimum 30% non-refundable deposit (which will be applied to the total cost of the retreat) is required to confirm my booking, or I may pay the full retreat cost upon registration. I understand that my balance must be paid in full at least 14 days prior to the start of the retreat to guarantee my space. If I make a deposit with a credit card, Mexisoul Retreats will charge that card automatically for the remaining balance 12 days prior to the start of my retreat. IF YOU CANCEL OR NEED TO RESCHEDULE THE RETREAT: • 45 days before: Full refund (minus 5% credit card fees) or the option to transfer the full amount to a future retreat within 12 months. • 45 to 30 days before: option to one time transfer of the full amount to a future retreat within 12 months. • 21 days or less before: No refunds on the 30% deposit, the remaining balance can be moved for a one time only to a future retreat within 12 months We do understand that things in life might happen, and we would be happy to take in consideration and move any retreat to a future date. If we have to cancel or postpone a scheduled retreat workshop due to unforeseen circumstances or events beyond our control (examples of such events are war, famine, political unrest, and/or “Acts of God”) you will be given full credit towards a future retreat for all payments paid. Please note: flights should arrive the day the retreat starts and depart the day the retreat ends or additional charges may occur.
Payments do not include the cost of plant medicines. *	I understand that payments made through Retreat Guru do not include the cost of: plant medicine, psychedelics or similar products. There will be no additional charges for this retreat.Supplementary Products Exclusion: Participants acknowledge and agree that these Fees presented and payable pertain solely to Services and Offerings, and will not include the cost of any plant-medicines or similar products (collectively, "Supplementary Products") which may be provided, offered, or distributed by a Commercial User, or any other party, in connection with Services or Offerings. Retreat Guru shall bear no responsibility or liability in connection with any provision, offering, or distribution of Supplementary Products, and is not a party thereto. All capitalized terms used herein shall carry the same meaning as assigned to them in Retreat Guru's Terms of Service.

7 Day August 2025 Psilocybin Retreat

1 Welcome

2 Price

Select an option*

Private Ranch Style Retreat

Semi Private Villa Retreat

Deluxe Room Retreat

3 People in your group

3 Optional Items

4 Participant Info

5 Agreements

6 Payment