Application Form
Guest Inquiry
Flexible Dates
We ask for a minimum stay of 10 nights so that a true taste of PachaMama can be experienced. There can be a shorter stay if you participate in a minimum 3-day workshop as this will drop you into the PachaMama energy field quickly. You are required to arrive the day before and stay until the day after it ends.
*
These fields are required
1
Choose the dates of your stay
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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
*
Sannyas Name
Email
*
Please use this email for all future registrations/payments/inquiries
Confirm email
*
re-type email address and confirm it is correct.
Country
*
United States
Canada
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua And Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia And Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Columbia
Comoros
Congo
Cook Islands
Costa Rica
Cote D'Ivorie (Ivory Coast)
Croatia (Hrvatska)
Cuba
Cyprus
Czech Republic
Democratic Republic Of Congo (Zaire)
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
France, Metropolitan
French Guinea
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Heard And McDonald Islands
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar (Burma)
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
Saint Helena
Saint Kitts And Nevis
Saint Lucia
Saint Pierre And Miquelon
Saint Vincent And The Grenadines
San Marino
Sao Tome And Principe
Saudi Arabia
Senegal
Seychelles
Sierra Leone
Singapore
Slovak Republic
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia And South Sandwich Islands
South Korea
Spain
Sri Lanka
Sudan
Suriname
Svalbard And Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad And Tobago
Tunisia
Turkey
Turkmenistan
Turks And Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Vatican City (Holy See)
Venezuela
Vietnam
Virgin Islands (British)
Virgin Islands (US)
Wallis And Futuna Islands
Western Sahara
Western Samoa
Yemen
Yugoslavia
Zambia
Zimbabwe
Birth Date
*
Jan
Feb
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2025
2024
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2015
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1932
1931
1930
1929
1928
1927
1926
1925
1924
Gender
*
--SELECT--
Male
Female
Other
Accommodation preference (1st choice)
*
Casita
Standard Bungalow
Upgraded Bungalow
AC Room
Cabina
Casa Luna (open air house)
AC Family Unit
Casa Sol (enclosed house)
Casa Bougainvillea (enclosed house)
Casa Kalimba (enclosed house)
Villa (enclosed house)
Casa Tierra (enclosed house)
Camping *Nov 20 to May 1
Accommodation preference (2nd choice)
*
Camping
Casita
Standard Bungalow
Upgraded Bungalow
AC Room
Cabina
AC Family Unit
Casa (open air house)
Casa (enclosed house)
If 1st choice is not available
Accommodation preference (3rd choice)
Camping
Casita
Standard Bungalow
Upgraded Bungalow
AC Room
Cabina
AC Family Unit
Casa (open air house)
Casa (enclosed house)
If 1st and 2nd choice are not available
Which workshops would you like to be registered for?
*
Magic of Tantra
Please list all workshops you would like to attend.
What pulls you to come to PachaMama?
please let us know in 200 words or so.
How did you discover PachaMama?
*
A friend
Google
Instagram
Facebook
YouTube
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Travel Companion(s) in same accommodation
*
Please enter: Name, Relationship and Email-address of all adults
If you are traveling with children, please specify the number of children and their ages.
Number of children, and their age (example: 2 children, age 8 and 11)
Comments or Special Requests
We cannot guarantee that it can be fulfilled
Medical Issues
*
In order to make sure we can support you. Please inform us of any health or psychological conditions and medications.
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
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