Unlearning Retreat Registration Form 
We are excited to welcome you to our Unlearning Retreats for the Summer of 2025. Your registration is your initial commitment to the program according to the dates that you select below. We will process and follow up with you approximately 2 weeks after your submission. If you should have doubts about any of the fields in the form, feel free to skip them for now and we will be in touch via email. If you have questions, please send an email to the retreat organizer, Daniel Bryan, at daniel@pachaysana.org

In our follow-up communications, we will provide you with a due date to submitting a $250 deposit, which guarantees your spot in the retreat. Space is limited so we will ask registrants to secure their spots as early as possible.  

Sign in to Google to save your progress. Learn more
Name *
Preferred Pronouns (he/him, she/her, they/them, she/them, he/them, etc)
Organizational Affiliation (if applicable)
Title or Position (if applicable)
Email *
Phone Number
Which of our two summer retreats are you registering for?
Select between the full 2-week retreat in the Highlands & Amazon (recommended) or the 1-week retreat in the Highlands-only
Clear selection
In one paragraph, please tell us why you are registering for the Unlearning Retreat. We want to know a bit about your story, personal goals and how you hope to apply this experience to your life and work. 
What is your Spanish Level? (Spanish is not required but it helps to know how many speakers we will have in the group.) 
Clear selection
Much of our retreat occurs in rural settings. While not required, some of our planned activities include long walks through challenging terrain. Do you require assistance or special accommodations related to physical mobility? 
Clear selection
If you answered YES or MAYBE, feel free to provide us with more information.
Do you have any other accessibility or accommodation requests that we should know about?  Please tell us if you have a disability, severe allergies or similar accessibility needs that might affect your participation in some way.  If none, leave blank.

Note: we can accomodate almost all dietary needs and will ask about restrictions and allergies in follow up communications.
About 50% of our retreat is community-based. Host communities are very comfortable, but they do not have amenities that many attendees are accustomed to. While each community has electricity, water, sanitation and internet, you must be prepared to live in what is often referred to as "rustic conditions." Please acknowledge your understanding of such conditions. 
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Fundación Pachaysana.

Does this form look suspicious? Report

Google Forms