Ayahuasca Retreat Registration

Ayahuasca retreat Registration form

Select your retreat format:

5-day short retreat

10-day full immersive retreat

30-day traditional Shipibo dieta

Private custom retreat — already arranged

Choose the private custom option only after the dates, price, program and number of ceremonies have been agreed with Feather Crown. Not arranged yet? Request your custom retreat and price quote first.

Prior agreement for your custom retreat(Required)

I confirm that the dates, price, program and number of ayahuasca ceremonies have already been agreed with Feather Crown.

Name of the person organizing your custom retreat(Required)

Enter the name of your group organizer or the Feather Crown contact with whom the custom retreat was arranged.

Select the 10-day event you wish to book:(Required)

Note: If you select an event which is currently full, you will be placed into its waiting list and notified when a space frees up.

November 23 - December 2, 2026 (10 days) $1790 - Ceremonies led by Don Carlos (Kichwa). RETREAT IS FULL

January 11 - 20, 2027 (10 days) $1990 - Ceremonies led by Maestro Sina (Shipibo). RETREAT IS FULL

January 28 - February 6, 2027 (10 days) $1990 - Ceremonies led by Maestro Sina (Shipibo)

February 13 - 22, 2027 (10 days) $1790 - Ceremonies led by Maestro Sina (Shipibo)

March 22 - 31, 2027 (10 days) $1790 - Ceremonies led by Don Carlos (Kichwa)

April 19 - 28, 2027 (10 days) $1690 - Ceremonies led by Don Carlos (Kichwa). EARLY BIRD PRICE

May 17 - 26, 2027 (10 days) $1690 - Ceremonies led by Don Carlos (Kichwa). EARLY BIRD PRICE

Select 5-day event you wish to book:(Required)

Note: If you select an event which is currently full, you will be placed into its waiting list and notified when a space frees up.

Select the 30-day event you wish to book:(Required)

Note: If you select an event which is currently full, you will be placed into its waiting list and notified when a space frees up.

January 11 – February 11, 2027 (30 days) $3700 - Led by Shipibo Maestro Sina. RETREAT IS FULL

January 28 – February 28, 2027 (30 days) $3700 - Led by Shipibo Maestro Sina

Deposit non-refundability and even cancellation akcnowledgement(Required)

I am aware that the booking deposit is non-refundable. However any deposit can be transferred to another date if done at least 30 days before the originally booked event begins. The deposit can also be transfrerred to another person for free any time. In case the even in cancelled, the organizer issues a full refund of any depodsits, but is not responsible for covering any losses due to event being cancelled. In order to prevent any losses, a travel insurance or refundable flight tariff is recommended.

Basic information

Your name:(Required)

Name Surname

E-mail(Required)

Enter Email Confirm Email

Phone

Gender:(Required)

Male

Female

Age:(Required)

Residency(Required)

City Country

Passport number(Required)

If you don't have your passport yet, please fill "0" and give us your passport number later.

Emergency contact (name, phone number):(Required)

Health condition

What is your current health condition?(Required)

Do you currently suffer from any of the following health conditions?(Required)

Any medicines or supplements that you are currently using:

Important information about prescribed medication: Some medications are incompatible with ayahuasca or require a sufficient interval before ceremony. When reducing or discontinuing a particular medication is necessary for safe participation, this is a condition of participation in our program, not a treatment instruction. You decide whether to change your medication and meet that condition. Before changing prescribed medication, we recommend first obtaining information from the clinician who prescribed it about the risks and a safe way to make the change. If you decide to proceed, tell us what you actually changed and when you took the last dose; based on the health screening, we will assess the required interval and your eligibility to participate.

Allergies:

Please list any recreational drugs you are using regularly:(Required)

Enter "none" if you are not currently using any recreational drugs.

Are you currently pregnant?

Yes

I understand that ayahuasca and all other sacred plants are purgatives and dangerous to consume while pregnant. If I become pregnant before the beginning of the tour, I understand that I am responsible for notifying Feather Crown and that I will not be able to ingest ayahuasca or any other sacred plant during pregnancy. I also understand that I will not be entitled to a refund.

Feather Crown Health Screening and Full Disclosure:

Medication, supplements and full disclosure policy(Required)

This retreat involves the ingestion of plant medicines that may be contraindicated with certain medical conditions, medications, or substances. All prescription medicines, over-the-counter medicines, supplements, herbal preparations and natural remedies taken within 30 days before the retreat, as well as any used during the retreat, must be fully disclosed during the application process. No medication or supplement may be used during the retreat unless Feather Crown has approved it in writing. Never stop prescribed medication or change its dosage without first consulting the qualified clinician who prescribed it. At the same time, inform Feather Crown about the treatment and agree on the procedure with us before arriving. By completing this application, you confirm that all information provided is true, complete, and current, and that you have fully disclosed all physical and psychological conditions, as well as all medications, supplements, and substances you are taking.

I agree to the Feather Crown Health Screening and Full Disclosure

Feather Crown Medical Responsibility and Liability Waiver

By checking the box below and typing my name, I confirm that: I have read and understood all provided medical and safety information I have fully disclosed all requested health and medical information All information I have provided is true and complete to the best of my knowledge I understand that: Falsifying or omitting relevant information may result in denial of participation, with or without refund, at the sole discretion of Feather Crown Ayahuasca and other plant medicines may be dangerous or life-threatening if combined with certain conditions or substances Feather Crown is not a medical facility Its owners, staff, employees, and agents do not practice Western medicine and are not licensed medical doctors I voluntarily assume full responsibility for my participation. I hereby waive, release, and hold harmless Feather Crown, its owners, staff, employees, and agents from any and all liability, claims, damages, or injuries that may occur in connection with my participation.

I have read, understood, and agree to the Medical Responsibility and Liability Waiver

Please type your name in CAPITAL letters:(Required)

Food, accommodation and transportation

Preferred diet:(Required)

Normal

Vegetarian

Vegetarian eating fish

Vegan

Any special requirements for your diet?

Preffered type of accommodation:(Required)

Private room for 1 person

Private Room for 2 people (2 beds) shared among friends or family

Let us know if there is somebody specific you want to share your room with:

Transport to and from the retreat center

Select the directions you would like us to arrange. Scheduled shared transfers on the first and last day of a complete 10-day retreat cost $50 USD per person each way. Private transfers between Quito airport or Tababela and the center cost $130 USD per vehicle each way. Other pickup locations or dates are quoted individually. For a 5-day stay, we confirm the arrangements for your exact arrival and departure dates. Arrival transport must always be prepaid, including when you pay the retreat balance in cash on arrival. Prepaying return transport is optional. We confirm your route, price and pickup time in the transport information.

Please arrange transport to Feather Crown on my arrival date

Please arrange transport from Feather Crown on my departure date

Work with the plants

Do you have any previous experience with Ayahuasca? If yes, what were the results?(Required)

What would you like to achieve and what are your expectations?(Required)

Referral (first time guests only)

How did you hear about Feather Crown? If it was from a website, which one? Thank you for helping us to understand how people find us.

Message to the organizers:

Anything that you want to add:

Make sure we receive your registration:

After you hit the submit button, you should receive an immediate confirmation email. If you don't receive the confirmation email within few minutes, something went wrong with your submission and you need to resend it. Make sure you fill all the obligatory fields, otherwise it won't let you send the form. You can always contact us at info@feathercrown.com if you have any problem.

Ayahuasca Retreat Registration