Kuntanawa 1-Night US Virgin Islands Plant Medicine Immersion Retreat

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1 Welcome

2 Price

3 People in your group

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.

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4 Optional Items

Genipapo: Basic Body Painting on your choice of hand, face, or foot

Sacred Body Paint: Embracing Ancestral Wisdom The Kuntanawa people hold a deeply spiritual tradition of adorning their bodies with sacred geometry symbols handed down from their ancestors. These intricate Jugua paintings are considered highly sacred, offering wearers protection and a profound connection to their spiritual path. The rituals of body painting are observed during ceremonies and festivals, with many Kuntanawans choosing to paint their bodies daily. Each individual's body paint carries specific blessings and serves as a shield against the sun's intensity in the Amazon. Every symbol and painting holds its own unique meaning, carefully selected based on the energy and intentions of the wearer. This mindful approach ensures that the direction, placement, and choice of symbols resonate harmoniously with the individual. During festivals, it is common for the Kuntanawa people to use the plant Urucum, which symbolizes moments of happiness and represents the color of love and beauty. Its elegant hues make it an ideal choice for festive occasions. On the other hand, Genipapo is predominantly used for ceremonial purposes, signifying the art of wisdom and a profound connection to the Earth and celestial spirits. According to Kuntanawa teachings, their ancestors reside in the stars, and wearing Jugua paint establishes a direct constellational pathway to ancestral knowledge that permeates from above and all around. Through the sacred practice of body painting, the Kuntanawa people not only honor their ancestors but also tap into a profound spiritual connection that shapes their identity and understanding of the world. This tradition serves as a living testament to the enduring wisdom and cultural heritage of the Kuntanawa tribe. (Genipapo is optional at the Retreats)

$77.00

Genipapo: In Depth Body Painting on your choice of arm, face, chest, etc...

$111.00

Genipapo: Advanced Body Painting (Back or 2 body part area)

$222.00

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5 Participant Info

6 1. Client Information

Select the day you would like to attend *	Friday Saturday
Date of Birth *
Emergency Contact Info *
Address
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Email newsletter	Please send me the email newsletter
Comments or Special Needs
Gender *
Requested Roommate
Special Diet
Diet Notes
How did you hear about us?
Discount code
The price reflects your donation for the experience. I understand all plant medicines offered are a gift from the tribe with my donation for the experience. *	I understand all plant medicines offered are a gift from the tribe with my donation for the experience.

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7 Medical Intake Information

What are your goals and intentions for this retreat? *
Do you have a spiritual practice? If so, please describe. *
Medical History: Please check any of the below conditions that you CURRENTLY have *	I do not have any medical conditions Anorexia Aspergers Aids/HIV Asthma Aneurysm Arthritis Bipolar Disorder Cancer Cardiovascular Issues Chest pains Chronic pain Coronary Issues Coronary Artery Bypass Surgery Covid 19 Cranial Injuries Dysrhythmia Diabetes Epilepsy Fibromyalgia Gynecological Acute Disease High blood pressure Heart Attack Heart Conditions (SEVERE- specify below) Hyperthyroidism Hypoxia Infectious Disease Low Blood Pressure Lung Conditions (severe- please specify below) Meningitis Migraines Multiple Sclerosis Neurological Disorders Obesity Personality disorders (please specify below) Pregnancy Schizophrenia Stroke Tuberculosis Tumor Ulcers Other: Please Describe Below
Other: Describe Here *
Do you currently use any recreational drugs that you will be unable to abstain from two weeks prior, during and after ceremony? If yes, please describe below *	Yes No
Drug Usage and History: Click All that apply *	Prescribed medications or therapies for mental health conditions that you will unable to safely abstain from two weeks before, during and after ceremony? Specify below. Currently use any recreational drugs that you will be unable to abstain from two weeks prior, during and after ceremony? Please describe below None of the above
Please list any and ALL medications, herbs or recreational drugs you will be using at least two weeks before, during or two weeks after ceremony.* *
Please list any diet restrictions: *
Spiritual Diet Information (Dieta)	Please refrain from ingesting red meat, salt, oil, sugar, or recreational drugs 3 days before this event. Refrain from alcohol and some drugs listed below for at least two to six weeks (see specific contraindications below). For optimal purity, the dieta can be done several weeks before to cleanse the body, mind and release attachments prior to the event to get the most out of your experience.
Contraindications	Our priority is your safety and well being, and to guide you to personal healing and growth. During the booking process you will be asked to fill out a medical questionnaire. Please be as forthcoming as possible when answering the questions. If any potential medical contraindications are present, we will inquire further to ensure your safety. By registering for a program, you are declaring that you are in physical and mental condition appropriate to the activities described in the workshop program, that you agree to participate at your own risk, and that we cannot accept liability for any accident or injury. We will provide the most secure environment to work with medicinal plants as much as possible and ensure your welfare to the best of our abilities, at all times. In return, we ask that you behave responsibly and do not endanger yourself or others. General Medical Precautions Working with medicinal plants can carry health risks; it is necessary that you disclose any known heart, liver, kidney, pancreatic, or other serious medical condition, and/or use of any medication at the time of booking. Those with diabetes or hepatic conditions must first consult with the host or Kuntanawa and provide more information about the condition. If you have a heart condition, chronic high blood pressure or tuberculosis please let us know so we can adjust dosage for you. Please contact us before making a reservation to discuss your particular case. Although the medicinal plants we use have not been found to cause psychosis or other psychiatric disturbances, it can be dangerous to those with a history of psychological conditions. Please inform us of any history of mental health problems in the past. It is important to suspend any kind of psycho-pharmaceutical and depression treatments 14 to 42 days before drinking some of our medicinal plants. We will provide more specific advice on how to proceed under the supervision of your doctor once we receive details of a particular medication in question. Contraindications From an Amazonian plant healer’s perspective: When a patient or apprentice is working with a medicinal plant, it is preferable to not take any other substances. This may cause cutipado or, in other words, interfere with the plant’s energy and provoke unwanted reactions. Certain drugs and medications have been found to not be compatible with some medicinal plants. It is essential to stop taking the substances listed in this document and give your system sufficient time to remove them from the body before you begin a program. We will provide advice on how to proceed during your booking process. Please consult your doctor if you are in any doubt. You should not stop taking prescribed medications without consulting your doctor. If you are taking any drugs or herbs it is important to review the information carefully below. For your safety, all drugs and herbs listed below should be discontinued in a safe manner at least 2 weeks (or more if indicated) before drinking some of our medicinal plants. Please consult your physician before changing your medical schedule. Herbal Contraindications for some of our medicinal plants: St. Johns Wort • Kava • Kratom • Ephedra • Ginseng • Yohimbe • Sinicuichi • Rhodiola Rosea • Kanna • Boswellia • Nutmeg • Scotch Broom • Licorice Root • Cannabis Interactions: Smoking marijuana before drinking some medicinal plants may stupefy and darken the overall experience, acting as a blockage. Given the general amplified sensitivity of all participants during the event, marijuana negatively affects not just the person who used it, but potentially other participants’ experiences as well as the overall energy of the medicine circle. It is important that your system is clear of cannabis at least 12 hours Contraindications: Drugs and Medications Any medication that contains MAO inhibitors (MAO-Is) are known to cause dangerous side effects when taken in conjunction with drinking some medicinal plants and should be suspended. Any medication that has an effect on the serotonin system, including Selective Serotonin Reuptake Inhibitors (SSRIs), can induce serotonin syndrome, with potentially fatal results when combined with some medicinal plants. We advise that SSRI medications be suspended SIX WEEKS prior to taking some medicinal plants to allow the system to clear in time. Some of these drugs may cause side effects when you stop taking them so you should allow plenty of time for these to subside and always consult your physician before changing your medical schedule. List of Contraindicated Drugs (3, 5): • Other MAO-Is • SSRI’s (any selective serotonin reuptake inhibitors) • Asthma inhalers • Antihypertensives (high blood pressure medicine) • Appetite suppressants (diet pills) • Medications for asthma, bronchitis, or other breathing problems • Antihistamines, medicines for colds, sinus problems, hay fever, or allergies (any cold, cough, or flu preparations, and any drug with DM, DX or -tuss in its name.) • CNS (central nervous system) depressants • Antipsychotics • Barbiturates • Tranquilizers • Sympathomimetic amines (including pseudo ephedrine and ephedrine) • Alcohol • Amphetamines • Opiates • Mescaline (any phenethylamine) • Barbiturates 4 of 9 Specific Contraindicated Drugs (3, 5): • Actifed • Adderall • Alaproclate • Albuterol (Proventil, Ventolin) • Amantadine hydrochloride (Symmetrel) • Amineptine • Amitriptaline • Amoxapine (Asendin) • Asarone/Calamus • Atomoxedine • Befloxetone • Benadryl • Benylin • Benzedrine • Benzphetamine (Didrex) • Bicifadine • Brasofensine • Brofaromine • Bromarest-DM or -DX • Bupropion (Wellbutrin) • Buspirone (BuSpar) • Butriptyline • Carbamazepine (Tegretol, Epitol) • Chlorpheniramine • Chlor Trimeton • Cimoxetone • Citalopram • Clomipramine (Anafranil) • Cocaine • Codeine • Compoz • Cyclobenzaprine (Flexeril) • Cyclizine (Marezine) • Dapoxotine • Desipramine (Pertofrane, Norpramin) • Desvenlafaxine • Dextroamphetamine (Dexedrine) • Dextromethorphan (DXM) • Dibenzepin • Dienolide kavapyrone desmethoxyyangonin • Diethylpropion • Dimetane-DX • Disopyramide (Norpace) • Disulfiram (Antabuse) • Dopamine (Intropin) 5 of 9 • Dosulepin • Doxepin (Sinequan) • Dristan Cold & Flu • Duloxetine • Emsam • Ephedrine • Epinephrine (Adrenalin) • Escitalopram • Femoxitine • Fenfluramine (Pondimin) • Flavoxate Hydrochloride (Urispas) • Fluoxetine (Prozac) • Fluvoxamine • Furazolidone (Furoxone) • Guanethedine • Guanadrel (Hylorel) • Guanethidine (Ismelin) • Hydralazine (Apresoline) • 5 Hydroxytryptophan • Imipramine (Tofranil) • Iprindole • Iproniazid (Marsilid, Iprozid, Ipronid, Rivivol, Propilniazida) • Iproclozide • Isocarboxazid (Marplan) • Isoniazid (Laniazid, Nydrazid) • Isoniazid rifampin (Rifamate, Rimactane) • Isoproterenol (Isuprel) • L dopa (Sinemet) • Levodopa (Dopar, Larodopa • Linezolid (Zyvox, Zyvoxid) • Lithium (Eskalith) • Lofepramine • Loratadine (Claritin) • Macromerine • Maprotiline (Ludiomil) • MDA • MDEA • MDMA (Ecstasy) • Medifoxamine • Melitracen • Meperidine (Demerol) • Metaproterenol (Alupent, Metaprel) • Metaraminol (Aramine) • Methamphetamine (Desoxyn) • Methyldopa (Aidomet) • Methylphenidate (Ritalin) 6 of 9 • Mianserin • Milnacipran • Minaprine • Mirtazapine (Remeron) • Moclobemide • Montelukast (Singulair) • Nefazodone • Nialamide • Nisoxetine • Nomifensine • Norepinephrine (Levophed) • Nortriptyline (Aventyl) • Oxybutynin chloride (Ditropan) • Oxymetazoline (Afrin) • Orphenadrine (Norflex) • Pargyline (Eutonyl) • Parnate • Paroxetine (Paxil) • Pemoline (Cylert) • Percocet • Pethedine (Demerol) • Phendimetrazine (Plegiline) • Phenelanine • Phenergen • Phenmetrazine • Phentermine • Phenylephrine (Dimetane, Dristan decongestant, Neo Synephrine) • Phenylpropanolamine (in many cold medicines) • Phenelzine (Nardil) • PMA • Procarbazine (Matulane) • Procainamide (Pronestyl) • Protriptyline (Vivactil) • Pseudoephedrine • Oxymetazoline (Afrin) • Quinidine (Quinidex) • Rasagiline (Azilect) • Reboxetine • Reserpine (Serpasil) • Risperidone • Robitussin • Salbutemol • Salmeterol • Selegiline (Eldepryl) • Sertraline (Zoloft) • Sibutramine 7 of 9 • Sumatriptan (Imitrex) • Terfenadine (Seldane D) • Tegretol • Temaril • Tesofensine • Theophylline (Theo Dur) • Tianeptine • Toloxatone • Tramidol • Tranylcypromine (Parnate) • Trazodone • Tricyclic antidepressants (Amitriptyline, Elavil) • Trimipramine (Surmontil) • Triptans • Tryptophan • Tyrosine • Vanoxerine • Venlafaxine (Effexor) • Viloxezine • Vicks Formula 44-D • Yohimbine • Zimelidine • Ziprasidone (Geodon) • Potential complications that can occur while taking these listed drugs in conjunction with some medicinal plants: Using stimulants with MAO-Is is particularly dangerous and can be potentially fatal. Using cocaine, amphetamines or MDMA (Ecstasy) with MAO-Is may cause a severe increase in blood pressure, increasing the chances for stroke and cerebral hemorrhage and making it possible to overdose on a relatively small amount of cocaine. (A fatality has been recorded involving combining Peganum harmala and cocaine. Fatalities resulting from combining amphetamines with pharmaceutical MAO-Is are recorded in medical literature.) Using other serotonin agonists or precursors with an MAO-I can lead to serotonin syndrome. The main symptom of serotonin symptom may be a severe and long-lasting headache (the same symptom as MAO-I tryptamine interaction) and/or fever (as high as 40 °C / 104 °F or more) Other symptoms of serotonin syndrome may include rapid heartbeat, shivering, sweating, dilated pupils, intermittent tremor or twitching, overactive or over-responsive reflexes, hyperactive bowel sounds, high blood pressure. Severe serotonin syndrome may lead to shock, agitated delirium, muscular rigidity and high muscular tension. renal failure, seizures, and can be life-threatening. Using Tricyclic antidepressants within two weeks of taking MAO-Is may cause serious side effects including sudden fever, extremely high blood pressure, convulsions, and death. Using Fluoxetine (Prozac) within five weeks of taking MAO-Is may cause high fever, rigidity, high blood pressure, mental changes, confusion and hypomania. Using Benzedrine, Benzphetamine, Desipramine, Desoxyn, Dexedrine, Dopamine, Ephedrine (contained in Marax, Quadrinal, and other asthma drugs), Epinephrine, 8 of 9 Guanadrel, Guanethidine, Hydralazine, Isoproterenol, L-dopa, Metaraminol, Methyldopa, Mirtazamine, Norepinephrine Oxymetazoline, Phendimetrazine, Phentermine, Phenylephrine, Phenylpropanolamine, Pseudoephedrine, Ritalin, or Venlafaxine with MAO-Is may cause a hypertensive crisis (severe spike in blood pressure). Using Adderall with MAO-Is can result in high body temperature, seizure, and in some cases coma. Using Bupropion (Wellbutrin) within two weeks of taking MAO-Is may cause serious side effects such as seizures. Using Buspirone (Buspar) with MAO-Is may cause high blood pressure and increased sedative effects. Using Carbamazepine (Tegretol) with MAO-Is may result in fever and may increase seizures, especially in epileptics. • Using Clomipramine with MAO-Is may cause high fever (hyperpyrexic crisis) and seizures. Using CNS depressants with MAO-Is may increase the depressant effects. Using Desipramine (Norpramin, Pertofrane) with MAO-Is may result in hypertensive crisis. Using Dextromethorphan with MAO-Is may cause excitement, high blood pressure, and fever, or brief episodes of psychosis. Using Fenfluramine with MAO-Is may result in fever (hyperpyrexic crisis). Using Lithium with MAO-Is may cause fever and serotonin syndrome. Using Meperidine (Demerol) with pharmaceutical MAO-Is has resulted in deaths from a single dose. Using Metaproterenol or other beta-adrenergic bronchodilators with MAO-Is may cause blood pressure elevation and rapid heartbeat. Using Mirtazapine (Remeron) with MAO-Is may result in hypertensive crisis. • Using Nefazodone (Serzone) may result in high fever. Using Temaril with MAO-Is may increase chance of side effects. Using Terfenadine with MAO-Is may cause an increase in MAO-I blood levels. Using Theophylline with MAO-Is may cause rapid heartbeat and anxiety. Using Trazodone (Desyrel) with MAO-Is may result in high fever. Using Tryptophan or L-tryptophan with MAO-Is may cause disorientation, confusion, amnesia, delirium agitation, memory impairment, hypomanic signs, shivering. Using Venlafaxine (Effexor) with MAO-Is may result in hypertensive crisis. Using Ziprasidone (Geodon) with MAO-Is may cause serotonin syndrome. Using alcohol with MAO-Is may cause side effects like angina (chest pain) or headaches. The headache may mask or be mistaken for hypertensive crisis caused by MAO-I interaction. MAO-Is can also increase the sedative effect of alcohol. Using opiates with MAO-Is carries a risk of respiratory depression. Using diuretics with MAO-Is may cause a greater drop in blood pressure than normal and increase in MAO-I blood levels. Using anesthetics with MAO-Is may potentiate the anesthetic effect. Using sleeping pills, tranquilizers (major or minor), or barbiturates with MAO-Is may increase the sedative effect. 9 of 9 References Hales RE, Yudolfsky SC, Talbott JA (Editors) (1994). American Psychiatric Press Textbook of Psychiatry. Washington, D.C.: American Psychiatric Press, Inc. 940-3. McCabe BJ (1986). Dietary tyramine and other pressor amines in MAO-I regimes: A review. Journal of The American Dietetic Association. 86:8:1059-64.
Code of Conduct & Sexual Integrity Agreement USA	It is important to understand that you are in a new place, during our work together. The culture may be very different from what you are accustomed to. We want to honor the ways of the land and people as well as prepare you for a safe experience. Here are some things you need to know: -Please remove shoes at the entrances of all buildings. Please do not wear shoes indoors (ceremony space). -Please do not enter anyone else’s ceremony space without their permission before, during and after the events. -Please use the toilets or buckets it, not the tree or bush to honor the safety of all. We don't want to cross contaminate or make anyone sick. -Please walk with a buddy at all times. It can be dangerous to walk alone. -Please do not put toilet paper or female products in the toilets. Throw all paper in trash containers. -Please refrain from jumping in any water areas (e.g., pools, sacred fountain) unless instructed -Please be very careful and respectful of the wildlife on the property. Do not approach any wildlife as It can be very dangerous. -Please be mindful of how much food you intake. Sharing is caring. Please eat at the appropriate time frames according to the retreat schedule. -Please only one mat per person in ceremonies (no larger than a yoga mat width). -Please clean your own dishware after you use it. -Please clean up after yourself at all times. -You are responsible for your items. -Please do not put anything on the altar or in the facilitator ceremony space unless you ask first. - Please make sure you check your shoes for any critters before putting them on at all times. Shake out your blankets or bedding before and after the ceremony. Bugs can crawl inside in some ceremony spaces. -Please be aware of personal modesty and attire in and out of the ceremony. Modesty allows you to protect your energy and the container created at the ceremony. -Emergency internet use only. Please explain to your family, friends, and work that you are on a journey and that you will call if there is an emergency but that you will be unavailable while you attend the event. Using the internet can bring up many triggers while working with the medicines. Take advantage of the opportunity to be disconnected and connect with the earth. -No double dipping spoons in community food to prevent fermentation and contamination. -Ask permission before touching or interacting with children and pets as they are vulnerable around different energies, bacterias and medicine. -Clean your bucket after the ceremony. -Clean up your trash and tissues after use. -No littering, especially of our natural surroundings. -Using quiet tones within/ after medicine, quiet spaces, or in the morning while others are in a medicine experience, ritual experience, integrating, meditating, sleeping or waking unless instructed otherwise, as to respect the other’s experience. -Using quiet tones while walking paths and hiking in the natural areas. This brings awareness to the surroundings, doesn’t disturb the wildlife and gives others and yourself a glimpse of the ecosystems in their natural form. -No mixing of other medicines within the event unless communicated with facilitators of Kuntanawa, as this can be harmful to yourself and others -Stay aware of what you touch and sit on during the day and night. The wilderness is alive and may be harmful if you are unaware. Flashlights or headlights are highly recommended at night. Please make sure to use low-light settings around others and in and around the ceremony space. -Please do not kill or disturb the natural areas and any creatures living outside your home (place that you are staying in) unless instructed, as it is important to understand this is their home too. -Do not take from the land unless you ask first or are instructed to do so. Some things are harmful to you if nature if taken. Please be respectful of the land owners and leave natural areas and property as you found it. Sexual Integrity Agreement -As we embark on this journey together we are opening many gateways to reach our healing. We become vulnerable and shed layers of ourselves as we open up to see deeper parts that we may not have been able to reach previously. We can become very vulnerable within our bodies and consciousness so it is important to keep a safety net around us. We ask that there is understanding surrounding the subject of intimacy and purification. We ask that all participants refrain from sexual activity during the event and recommend no sexual activity 3 days prior and 3 days after the ceremony; especially with new partners.
I have read, understand and agree to the above mentioned Spiritual Diet, Contraindications, Code of Conduct and Sexual Integrity Agreement for attending this Kuntanawa Event. *	I understand and agree
DATE *

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8 Private Ministerial Association KUNTANAWA NATION MEMBERSHIP

MEMBERSHIP APPLICATION	KUNTANAWA NATION - A Private Ministerial Association By joining Kuntanawa Nation, a Private Membership Association and/or any website or Social Media Group started by, created by, maintained, or organized by the Association, I agree to the terms and conditions of Kuntanawa Nation, a Private Membership Association, Agreement as follows. This Association of members declares that our objective is to allow the Private Membership Association founders and all Private Membership Association members with a platform in which to conduct all manner of private business with the Association and with other Associations and Association members, keeping all business in the private domain and utilizing the protections guaranteed by the Universal Declaration of Human Rights (UDHR), the Constitution to conduct business in private and to provide a platform for members to conduct business in the private domain under all protections acknowledged and guaranteed by the Constitution of the UNITED STATES, and any previous protections guaranteed. We believe that the Holy Scriptures, the Universal Declaration of Human Rights (UDHR), the Constitution of the United States of America, the various constitutions of the several states of the union, and the Charter of Rights of Canada guarantees our members the rights of absolute freedom of religion, free speech, petition, assembly, and the right to gather together for the lawful purpose of helping one another in asserting our rights protected by those Constitutions, Charter and Statutes, in addition to the rights to be free from unreasonable search and seizure, the right to not incriminate ourselves, and the right to freely exercise all other unalienable rights as granted by our creator, our almighty God and guaranteed by those Constitutions, Charter, and Statutes. WE HEREBY Declare that we are exercising our right of “freedom of association” as guaranteed by the Universal Declaration of Human Rights (UDHR), the U.S. Constitution and equivalent provisions of the various State Constitutions, as well as the Charter of Rights of Canada. This means that our Association activities are restricted to the private domain only and outside of the jurisdiction of government entities, agencies, officers, agents, contractors, and other representatives as provided by law. We declare the basic right of all of our members to decide for themselves which Association members could be expected to give wise counsel and advice concerning all matters including, but not limited to physical, spiritual, and mental health care assistance, law, and any other matter and to accept from those members any and all counsel, advice, tips, whom we feel are able to properly advise and assist us. We expect the freedom to choose and perform for ourselves the types of therapies and treatments that we think best for diagnosing, treating and preventing illness and disease and for achieving and maintaining optimum wellness, as well as the freedom to choose for ourselves any types of assistance which may be made regarding law and any other private business activity. The mission of this Association is to provide members with a forum to conduct business between members in the private domain with the protections guaranteed within the aforesaid Constitution and Charter remaining fully intact. The Association will recognize any person(s), natural or otherwise (irrespective of race, color, or religion) who have joined this Association or any social media group organized, created, or managed by this Association and is in agreement with these principles and policies as a member of this Association, providing said person has not been sanctioned, exercised, or otherwise banned by the association, and will provide a medium through which its individual members may associate for actuating and bringing to fruition the purposes heretofore declared. Membership to this Association, "Kuntanawa Nation", and any of its groups may be terminated by the association Trustees or their designee, at any time, should they conclude that a specific member is interacting with them or any other members in a way that is contrary or detrimental to the focus, principles, and betterment of this Association. I understand that, since The Association is protected by the First and Fourteenth Amendments to the U.S. Constitution, it is outside the jurisdiction and authority of Federal and State Agencies and Authorities concerning any and all complaints or grievances against The Association members or other staff persons. All rights of complaints or grievances will be settled by an Association designee, committee, or tribunal and will be waived by the member for the benefit of The Association and its members. By agreeing to this membership form I agree that I have sought sufficient education to determine that this is the course of action I want to take for myself. I agree to join Kuntanawa Nation, a private membership association under common law, whose members seek to help each other achieve better health and good quality of life. A. I am voluntarily changing my capacity from that of a public person to that of a private member. My activities within The Association are a private contractual matter that I refuse to share with the Local, State, or Federal investigative or enforcement agencies. I fully agree not to pursue any course of legal action against a fellow member of The Association, unless that member has exposed me to a clear and present danger of substantive evil, and upon the recommendation and approval of the Association I enter into this agreement of my own free will without any pressure or coercion. I affirm that I do not represent any Local, State or Federal agency whose purpose is to regulate and approve products or services, or to carry out any mission of enforcement, entrapment or investigation. I have read and understood this document, and my questions have been answered fully to my satisfaction. I understand that I can withdraw from this agreement and terminate my membership in this association at any time, and that my membership can and will be revoked if I engage in abusive, violent, menacing, destructive or harassing behavior towards any other member of The Association. These pages consist of the entire agreement for my membership in The Association.
Membership Agreement *	I agree this contract began on the date of my joining "Kuntanawa Nation". I declare that by joining this Association and/or the Associations websites and/or social media group(s), I have carefully read the whole of this document above and I understand and agree with it.
DATE *
Membership Message	By CHECKING the form above you are automatically considered a short-term member of Kuntanawa Nation’s Ministry’s Membership called Circle of the Stars for the duration of this event and are protected through Kuntanawa Nation when working with Kuntanawa Nation Sacred Medicines for the duration of this event. Donations for our events go to supporting the setup and function of the event as well as directly helps the Kuntanawa people who are in reconstruction of the people from genocide and slavery. By supporting the people directly, this provides jobs and quality of life of the people as well as honors their culture and traditions. If you would like to support the Kuntanawa Nation as a long-term member links to membership will be available upon submission of this application.
http://kuntanawanetwork.com/ *	I agree to become a member of Kuntanawa Nation by making at least one monetary donation of my choosing towards a subscription, which ensures the protection of my rights within the Ministry of Kuntanawa Nation. The subscription can be canceled at any time and serves as proof of membership. After submitting the application, you will be prompted to join kuntanawanetwork.com and become part of the "Circle of the Stars," the Kuntanawa Nation ministry. Within this group, you will have access to monthly hape and integration calls and exclusive information to support your spiritual practice of plant medicines. All donations contribute to supporting the infrastructure of the church’s initiatives and mission, as well as supporting the Kuntanawa Nation people, who safeguard the sacred Amazon and its inhabitants.

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9 Safety, Disclosures and Privacy Agreements

Agreement 1 *	Have have read and understood the above contraindications. I understand that taking other drugs or herbs may be harmful to my health. If I need to stop a prescribed medication I will ensure it is done safely and consult my physician if needed.
Agreement 2 *	You agree that you are in physical and mental condition appropriate to the activities described in the event, that you agree to participate at your own risk, and that we cannot accept liability for any accident or injury.
Agreement 3 *	Nondisclosure Agreement: By participating in this event you agree that you will not disclose the identities or actions conducted by any participant during the event without their expressed permission.
Agreement 4 *	Please indicate this form was filled out honestly and to the best of your ability.
Agreement 5 *	You will not disclose the event's location without permission from your host or the Kuntanawas.
Agreement 6 *	If you wish to invite someone to this event please get permission from your host or the Kuntanawa Nation before sharing any information sent by them.
Photo Release Agreement *	By checking this section, I acknowledge that I have completely read and fully understand the above release and agree to be bound thereby. I hereby release any and all claims against any person or organization utilizing these materials for entertainment purposes.
Photograph & Video Release	I hereby grant permission to the rights of my image, likeness and sound of my voice as recorded on audio or videotape without payment or any other compensation. I understand that my image may be edited, copied, exhibited, published, or distributed and waive the right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of my image or recording. By signing, I understand this permission signifies that photographic or video recordings of me may be electronically displayed via the Internet or in the public educational setting. I will be consulted about the use of the photographs or video recording for any purpose other than those listed above. There is no time limit on the validity of this release nor is there any geographic limitations on where these materials may be distributed. This release applies to photographic, audio or video recordings collected as part of the sessions listed on this document only.
DATE *

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10 Accident Waiver Release of Liability Form

Waiver Agreement 1 *	I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING OR ATTENDING THIS ACTIVITY OR EVENT, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by the event, or because of their possible liability without fault. I certify that I am physically fit and have completed the medical questionnaire and/or have not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems which preclude my participation in this activity or event. I acknowledge that this Accident Waiver and Release of Liability Form will be used by the event holders, sponsors, and organizers of Kuntanawa, and that it will govern my actions and responsibilities at said activity or event. In consideration of my application and permitting me to participate in this event, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows:
Waiver Agreement 2 *	WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this event.*
Waiver Agreement 3 *	INDEMNIFY, HOLD HARMLESS, AND WILL NOT TO SUE the entity and/or persons organizing this event and waive them from any and all liabilities or claims made as a result of participation in this activity or event, whether caused by the negligence of release or otherwise. I acknowledge that this activity or event may test a person’s physical and mental limits and may carry with it the potential for death, serious injury, and property loss. The risks may include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of participants, equipment, vehicular traffic, actions of other people including, but not limited to, participants, volunteers, spectators, coaches, event officials, and event monitors, and/or producers of the event, and lack of hydration. These risks are not only inherent to participants, but are also present for volunteers. I am aware that physical activity will increase my risk of hypoglycaemia due to my condition (type 1 diabetes mellitus) and I will ensure that I will take every preventative precaution necessary. I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during this activity or event. I understand that at this event or related activities, I may be photographed. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose by the event holders, producers, sponsors, organizers, and assigns. The accident waiver and release of liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. I CERTIFY THAT I HAVE READ THIS DOCUMENT, AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL
DATE *
Payments do not include the cost of plant medicines. *	I understand that payments made through Retreat Guru do not include the cost of: plant medicine, psychedelics or similar products as it is considered a gift with retreat attendance.. There will be no additional charges for this retreat.Supplementary Products Exclusion: Participants acknowledge and agree that these Fees presented and payable pertain solely to Services and Offerings, and will not include the cost of any plant-medicines or similar products (collectively, "Supplementary Products") which may be provided, offered, or distributed by a Commercial User, or any other party, in connection with Services or Offerings. Retreat Guru shall bear no responsibility or liability in connection with any provision, offering, or distribution of Supplementary Products, and is not a party thereto. All capitalized terms used herein shall carry the same meaning as assigned to them in Retreat Guru's Terms of Service.

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Kuntanawa 1-Night US Virgin Islands Plant Medicine Immersion Retreat

1 Welcome

2 Price

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USVI Private Bed - Shared Cottage

3 People in your group

4 Optional Items

5 Participant Info

6 1. Client Information

7 Medical Intake Information

8 Private Ministerial Association KUNTANAWA NATION MEMBERSHIP

9 Safety, Disclosures and Privacy Agreements

10 Accident Waiver Release of Liability Form

11 Donate

12 Payment