Master Plant Dieta Consent Form

About This Journey
You have been invited to participate in a sacred pilgrimage and traditional plant dieta in the Peruvian jungle, organized by Soultech Sanctum and Ancestral Reunion. This is a spiritual journey rooted in indigenous healing traditions and the sincere religious practices of both organizations. The sacraments and master plants you will be working with during this dieta are administered by the retreat center and its practitioners under their guidance and tradition.

Soultech Sanctum and Ancestral Reunion serve as your spiritual guides and pilgrimage organizers—we hold the container, support your process, and walk this path alongside you. By signing this form, you acknowledge that you understand the nature of this journey and freely choose to participate.

1. Acknowledgment of Sacraments & Spiritual Practices
I understand that this pilgrimage includes participation in traditional ceremonial practices involving the following sacraments and master plants:

• Ayahuasca—a sacred plant medicine brewed from Amazonian plants, used in traditional ceremony for purification, visionary experience, and spiritual communion
• Tobacco (Mapacho)—a sacred tobacco preparation used for cleansing, grounding, and spiritual connection
• Sangre de Drago (Dragon’s Blood)—a traditional Amazonian tree resin used as the primary master plant for the dieta

I acknowledge that these are sacred spiritual practices, not medical treatments, therapy, or recreational activities. No specific outcome—physical, emotional, or spiritual—is promised or guaranteed.

2. Understanding of Risks
I understand that participation in this pilgrimage and dieta involves inherent risks, including but not limited to:

• Physical effects of ceremonial sacraments, including nausea, vomiting, purging, diarrhea, dizziness, changes in body temperature, and physical discomfort
• Emotional and psychological intensity, including difficult emotions, memories, or states of consciousness that may arise during or after ceremony
• Dietary restrictions required by the dieta process, which may cause discomfort or physical adjustment
• Environmental risks associated with being in a jungle setting, including insects, heat, wildlife, uneven terrain, and limited access to modern medical facilities
• Travel risks inherent to international travel

I accept these risks freely and voluntarily as part of my spiritual commitment to this journey.

3. Health Disclosure
I affirm that:

• I have truthfully disclosed all relevant medical conditions, medications (prescription and non-prescription), supplements, and mental health history on the retreat center’s intake form and/or directly to my pilgrimage leaders (Shamama and Txana)
• I understand that certain medications and health conditions may be contraindicated with the sacraments used in ceremony, and that withholding information could endanger my life or health
• I take personal responsibility for my decision to participate, including ensuring I have followed all preparation guidelines provided to me
• I have had the opportunity to ask questions and have them answered to my satisfaction

4. Voluntary Participation & Right to Withdraw
My participation in this pilgrimage is entirely voluntary. I understand that:

• I may decline to participate in any ceremony or activity at any time, for any reason, without judgment
• I may withdraw from the pilgrimage at any point, understanding that logistics and costs related to early departure are my own responsibility
• Shamama, Txana, or the retreat center practitioners may, at their discretion, recommend that I sit out of a particular ceremony for safety or spiritual reasons, and I agree to honor that guidance

5. Release of Liability
I, the undersigned, release and hold harmless the following from any claims, damages, injuries, or losses arising from my voluntary participation in this sacred pilgrimage:

• Soultech Sanctum and its leader, Shamama, and any associated facilitators or space-holders
• Ancestral Reunion and its leader, Txana, and any associated facilitators or space-holders

This release covers the full scope of the pilgrimage—including travel coordination, spiritual guidance, ceremonial support, and community activities—except in cases of gross negligence or willful misconduct.

I understand that Soultech Sanctum and Ancestral Reunion are spiritual organizations providing pilgrimage guidance, and that the retreat center and its practitioners bear their own responsibility for the ceremonies and medicines they administer.

6. Confidentiality & Sacred Container
I agree to honor the sacred container of this journey by:

• Keeping the identities, personal stories, and experiences of all participants confidential
• Not sharing specific details of other participants’ ceremonial experiences without their explicit permission
• Understanding that what is shared in ceremony and in circle stays within the circle

This commitment to confidentiality is a spiritual agreement rooted in respect, trust, and the safety of our community.

8. Emergency Contact

9. Signature
By signing below, I confirm that I have read and understood this entire form, that I am at least 18 years of age, that I am participating of my own free will, and that I accept the terms described above.