• If you cannot enter number, put in comments at end of form.
  • Date Format: MM slash DD slash YYYY
    If you stay a few days before or after the retreat, here are the prices for non-retreat nights at Gaia Sagrada
  • Date Format: MM slash DD slash YYYY
    Do you want to pay for a load of laundry? Some people find that they need to do laundry at some point during the retreat. Your clothes are washed, dried and folded for you.
    I understand that if I am staying for more than 2 nights I am expected to chip in an hour per day (or pay $10/day extra if I don't do Karma Yoga) to help keep things clean and orderly. I will chip in when I see something that needs to be done, like weeding in the gardens, sweeping a floor, dishes in the kitchen, plants needing water, bringing in firewood, etc. This helps Gaia Sagrada keep the prices low! I understand that there is no heavy lifting expected of me. Thank you for giving me a chance to save money this way!
    This is optional so that people on a budget can have a slightly lower price for the retreat. The shamanic cleansing is really wonderful, everyone raves about them, so you might want to treat yourself to this! The shaman does a personal session with you for 30-45 minutes to help you clear your energy, address physical issues you might have, and get ready for the ceremonies that follow in the retreat. They are offered before the first ceremony of the retreat.
  • Transportation to Gaia Sagrada $35 (required) / Extra Nights / Shamanic cleansing $35 (optional) / No Karma Yoga, just relax $120 (optional) / Security Box $12 (optional) / Laundry $5 (optional)/Heater
  • Emergency Contacts (required for Shamanic Retreat participants)

    For each emergency contact, please include name and relationship to you, address, phone number, and email address. We will not contact either person unless there is an emergency and we will not put either one on an email list. We respect privacy rights.
  • (father, mother, brother, sister, friend, etc.)
  • (father, mother, brother, sister, friend, etc.)
    This email list is connected to University of Metaphysical Sciences. (We don't send emails out very often, so we promise you won't be bombarded. Also, we never share our lists with anyone else, so you will only get emails from us)
  • Shamanic Ceremony Questionnaire

    Your answers to these questions are given to the shamans. Tell the shamans what you hope to heal, gain, or experience in these ceremonies!
  • Agreements

    I understand that Gaia Sagrada cannot provide me with medical attention nor does Gaia Sagrada have a doctor or nurse on site. I understand that the hospital is approximately an hour away. I am alerting Gaia Sagrada in the "special dietary or medical needs" section if I have health conditions which staff needs to know about for my safety. By submitting my reservation for a Shamanic Ceremony Retreat at Gaia Sagrada, or any other type of stay at Gaia Sagrada, I understand that my health and well-being is my responsibility and not that of Gaia Sagrada, staff, or associates thereof. I am bringing medicines I need with me, I have consulted with my doctor if I feel the need, and I have enough money to take care of my own health needs. If I have signed up for the shamanic retreat, or choose to when I am there, I take full responsibility for my experiences or reactions to the Sacred Ceremonies. I choose to participate in Sacred Ceremonies, or simply stay at Gaia Sagrada without being a participant in the retreats, of my own free will. If participating in the shamanic ceremonies, I know that I will be partaking in plant medicine teas. Whatever type of stay at Gaia Sagrada I choose, I promise to be careful, follow directions, and ask for help if I should need assistance in any way whatsoever.
    By submitting this reservation, I do not hold Gaia Sagrada, University of Metaphysical Sciences, Wisdom of the Heart Church, nor any employee thereof responsible for my belongings, health issues, or any other unforeseen circumstances. I have read and agree to the cancellation/refund policies ( and understand that all events, classes, workshops, and retreats are for entertainment and relaxation purposes only, not therapeutic in nature.
  • Please comment on anything not covered by the questions on this form. For example, let us know if you have special needs, or remind us of arrangements you made through previous emails or phone calls, or include anything else you would like to share!