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

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Guest 1		First Name* Last Name* Email* Gender*
Guest 1		First Name* Last Name* Email* Gender*

After completing this form, emails will be sent to everyone in your group to complete their information.

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 *
Choice of Family accomadations	Family accommodations have a private bathroom and cooking facilities
2nd Choice of Family accomadations	in case the first choice is not available.
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