Request edit access
La Fogata Retreat Application

Welcome to La Fogata: Ignite the Spark Within  | February 22nd - March 1st, 2026✨

We’re honored that you feel called to join us for this 8-day introduction to plant medicine and wellness retreat in Puerto Escondido, Mexico. La Fogata was created as a safe, supportive, and transformative space for those seeking depth, connection with others, and re-connection to your truth.

This application helps us get to know you, understand your intentions, and ensure that your participation is safe for everyone. Please answer all questions honestly and with care. All information shared is kept confidential.

⚠️ Important: Certain medical conditions and medications (including SSRI antidepressants) are contraindicated with plant medicine. Your safety is our priority, so transparency here is essential.

Take your time, breathe, and let your answers reflect where you are in your journey. We look forward to reviewing your application and hopefully welcoming you to La Fogata.

Sign in to Google to save your progress. Learn more
Email *
Full Name *
Date of Birth *
MM
/
DD
/
YYYY
Phone Number/WhatsApp Number *
Country of Residence *
Intentions & Alignment
What are your main motivations to do this? 
What inspired you to apply for La Fogata? *
What are you currently seeking in your life that you hope this retreat will support? *
Have you ever participated in a retreat, ceremony, or healing container before? If yes, please describe your experience with honesty. *
How would you describe your current relationship with yourself (physically, emotionally, spiritually)? *
What is one intention you would like to bring into this retreat experience? *
Health & Safety
⚠️ Your safety is our top priority. Please answer honestly. All responses are kept strictly confidential.
Do you currently take any prescription medications? (Please list all, including dosage and frequency.) *
Are you currently taking antidepressants or SSRI medications? (These are contraindicated with plant medicine.) *
Do you have a history of heart conditions, high blood pressure, seizures, or other serious medical conditions? *
If yes, please explain:
Do you have any diagnosed psychiatric conditions (e.g., bipolar disorder, schizophrenia, psychosis) that we should be aware of? *
If yes, please explain
Do you have any allergies or dietary restrictions? If yes, please explain. *
Do you consume alcohol or use recreational substances regularly? If yes, please describe. *
Women Only: Are you pregnant, breastfeeding, or planning to become pregnant?
Clear selection
Do you have any physical limitations or injuries that might affect your participation in movement practices, hikes, or ceremonies? If yes, please explain. *
Emotional Preparedness 
How do you manage your emotions (practices, coping mechanisms, self awareness, etc)?
How do you usually process challenging emotions or experiences? *
Do you currently have a therapist, coach, or support system you lean on? *
How comfortable are you with being in group settings and sharing personal experiences? *
Not Comfortable At All
Will Share my Life Story with a complete stranger
Final Notes
Is there anything important you want to share with us?
How did you hear about La Fogata? *
Is there anything else you’d like us to know before reviewing your application?
Agreement
I confirm that all information provided is accurate and complete. I understand that withholding health information may put myself and others at risk.  *
I acknowledge that certain medical conditions and medications (including SSRIs) are contraindicated with plant medicine and may affect my eligibility to participate. *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report