Register Mindfulness and the Medicine Ayahuasca Retreat September 30 - October 12, 2017 Retreat Guru is the online booking agent for Temple of the Way of Light. Returning Visitor? Click here to login. Login If you've already participated in a previous program, login to populate this form or to use any existing program credit. You may also continue without logging in. Username or Email Password Lost Password? * These fields are required Price Select a price $1,950.00 – Mindfulness and the Medicine: A New Paradigm in Healing Participant Info First Name * Last Name * Email * Gender *SELECTMaleFemale Country *United StatesCanadaAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua And BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia And HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColumbiaComorosCongoCook IslandsCosta RicaCote D'Ivorie (Ivory Coast)Croatia (Hrvatska)CubaCyprusCzech RepublicDemocratic Republic Of Congo (Zaire)DenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuineaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard And McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMoroccoMozambiqueMyanmar (Burma)NamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSaint HelenaSaint Kitts And NevisSaint LuciaSaint Pierre And MiquelonSaint Vincent And The GrenadinesSan MarinoSao Tome And PrincipeSaudi ArabiaSenegalSeychellesSierra LeoneSingaporeSlovak RepublicSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia And South Sandwich IslandsSouth KoreaSpainSri LankaSudanSurinameSvalbard And Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTokelauTongaTrinidad And TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVatican City (Holy See)VenezuelaVietnamVirgin Islands (British)Virgin Islands (US)Wallis And Futuna IslandsWestern SaharaWestern SamoaYemenYugoslaviaZambiaZimbabwe Phone Birth Date * Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2027 2026 2025 2024 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 Emergency Contact Person *Please write their full name Relationship to Emergency ContactAre they your brother, sister, mother, father, friend, etc? Emergency Contact's Phone * Country of residence of Emergency Contact Person Dietary Preference *NonePescatarianVegetarianVegan Special Dietary Requirements/Food Allergies Do you know anyone else attending this workshop? We know you did your research. Why did you choose to apply for a retreat the Temple over other centers? Please describe your reasons for choosing this program over the other programs that we offer. Email newsletter Please add me to the newsletter mailing list. PayPal email addressIf you would like to pay via PayPal, please provide the email address associated with your PayPal account. We will issue your invoice(s) to this email address once your application and medical form have been approved. Terms and Conditions * I accept the following Terms and Conditions: View Terms and Conditions Payment Sub Total$0 Taxes$0 Total$0 Choose Payment OptionCredit CardPayPal You will be asked for credit card details in the next step. Click the button below to continue. Register now Retreat Guru is the online booking agent for Temple of the Way of Light. Secure payments via Braintree . Charges will appear on your bill as "RG *TempleLight" Payment Terms & Important Notes: A 50 % deposit or the full workshop fee is required to confirm your reservation. Paying in installments is for your convenience only. It is possible to pay the retreat cost in one full amount, if you prefer. Any outstanding workshop cost must be paid AT LEAST 6 weeks prior to the program start to guarantee your booking. Please note that if you have paid via credit card, your card will be charged automatically for your remaining balance 6 weeks prior to the start of your workshop. Also, please DO NOT book flights until we have confirmed your booking. We are not liable for any flight costs that are incurred before your booking has been confirmed. We cannot confirm a booking until your medical questionnaires have been reviewed and approved by our staff AND we have received a deposit. A portion of each workshop income funds the critical projects on environmental justice, sustainable development, and intercultural education run by our Peruvian NGO, The Chaikuni Institute, as they implement outreach programs in indigenous communities in the Amazon. Cancellation Terms & Advice: Please note that we rely heavily on the workshop fees to fund our NGO activities and to fulfill our commitments to ongoing community based projects, which makes the following cancellation policy necessary. Upon cancellation, payments are only refundable or transferrable to a alternate retreat start date provided we have AT LEAST 8 weeks notice. For cancellations made less than 8 weeks before the workshop start date, we will only be able to refund your payment or credit it to a future date if we can fill your place in the workshop. We will try our best to do so. Any refunds given will incur a USD 100.- administration fee. We cannot refund any part of your payment after you have started your program. We strongly recommend that you take out adequate travel insurance for any cancellations due to unforeseen circumstances. Squaremouth is an insurance service we can suggest that can cover not only retreat costs but also possibly airfare costs.