Weekend Retreat Space Holder Application

March 13 - 15, 2026

With Alex Myrin and Jacquelyn Myrin

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1 Welcome

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2 Price

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General A/C'd Accommodations Area

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$350

$350

$350
General A/C'd Accommodations Area

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3 Participant Info

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What are your intentions or goals for participating in this ceremony?
Please list any prescription medications or supplements you currently take or have taken in the last 30 days
Do you have a history of any of the following medical conditions.	Crohn's disease Heart conditions High blood pressure Irritable bowel syndrome Seizures Self or family history of Bipolar/ Schizophrenia None of the above
If you answered yes to any of the above, please expand on the details
Do you use any alcohol, marijuana or any other recreational drugs	Yes No
Please elaborate, last time, how much and how often
Terms and Conditions	I accept the terms and conditions.Deposits and payments are non-refundable but may be used as a credit towards future bookings.
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.

4 Donate

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$	Donate to the scholarship fund Donation Your donation will anonymously sponsor the ceremony participation of someone in need who otherwise could not afford to participate.

5 Payment

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.

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