Application Form
Family Guest Inquiry
Flexible Dates
We ask for a minimum stay of 10 nights so that a true taste of PachaMama can be experienced.
*
These fields are required
1
Choose the dates of your stay
Check In
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2
People in your group
Guest
1
First Name
*
Last Name
*
Email
*
--SELECT--
Male
Female
Other
Gender
*
Guest
1
First Name
*
Last Name
*
Email
*
--SELECT--
Male
Female
Other
Gender
*
After completing this form, emails will be sent to everyone in your group to complete their information.
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3
Participant Info
First Name
*
Last Name
*
Email
*
Please use this email for all future registrations/payments/inquiries
Confirm email
*
re-type email address and confirm it is correct.
Birth Date
*
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Choice of Family accomadations
Casa Tierra (enclosed house)
Villa (enclosed house)
Casa Kalimba (enclosed house)
Casa Bougainvillea (enclosed house)
Casa Sol (enclosed house)
AC Family Unit
Casa Luna (open air house)
Cabina
AC Room with Kitchenette
UpGraded Bungalow
Family accommodations have a private bathroom and cooking facilities
2nd Choice of Family accomadations
Casa Tierra (enclosed house)
Villa (enclosed house)
Casa Bougainvillea (enclosed house)
Casa Kalimba (enclosed house)
Casa Sol (enclosed house)
Casa Luna (open air house)
AC Family Unit
Cabina
AC Room with Kitchenette
Upgraded Bungalow
in case the first choice is not available.
What pulls you to come to PachaMama?
*
please let us know in a few words what you are seeking
Have you lived in community before?
*
Please share the benefits and the challenges you experienced.
Do you have experience with Meditation, Silence or other spiritual practices?
*
Experience required but is one of the pillars of PachaMama.
Will there be others sharing your room?
*
Name and Email-address of all adults + number and ages of children.
Your children's ages
*
Please provide your children's ages to assist us in finding suitable accommodation for your family
Family Medical History
*
In order to make sure we can support you and your family Please inform us of any health or psychological conditions and medications.
Which workshops are you interested in joining?
Email newsletter
Please send me the email newsletter
Cancellation policy agreement
*
With your registration you agree to our terms and conditions.
See our Cancellation Policy here
Promo Code
enter promo code
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