Peru Sacred Journey with the Shamans: Personal Application

Please complete the following Personal Application so that we may ensure your ability to participate.

Peru Sacred Journey with the Shamans

Personal Application
Name

First NameLast Name
Email
example@example.com
Cell Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Tell us about yourself:
Why do you want to embark on this journey?
Peru is a high altitude destination with many uneven surfaces. What is your level of fitness?

Other
Please tell us more about your injury and recovery process
What is your age range?
What is your daily personal energy level?
Do you have a history of any injuries to your knees, feet, legs or back?
Please explain:
Peru does not have a wide variety of specialty foods. Please explain your diet and what you need to eat to feel energized?
Is your diet:
Can you eat primarily vegetarian meals for 8 days?
Are you willing to purchase trip insurance?
Anything else you want us to know about you…
Thank you for your answers
Should be Empty: