2018 Trip Registration

Please fill out the required areas below and sign using an electronic signature (type your name as it appears on your passport) at the bottom of this page. We will not accept anyone who has not completely filled out, signed and submitted this form.

By submitting this form you assure us you have read and completely understood the "Tour Itinerary" section and the "Terms and Conditions" section, and that you completely agree. 

If you elect to participate in the Ayahuasca Ceremony you understand you are required to sign a release form. This form is available upon your available at the jungle lodge. Without this release form, you will not be allowed to participate in the Ayahuasca Ceremony.

If you are joining the trip at the last minute you are required to print off the completed registration form and deliver it to Jerry or Kathy Wills upon your arrival to Lima or, if this isn't possible due to any reason, deliver it to Jerry or Kathy Wills once you reach the Amazon Rainforest Lodge. Without this, you might not be accepted to join this trip.

An electronically signed application and your deposit must be received to secure your space on this trip. 

Once you have completed this form your deposit is needed to finalize your registration. Trip deposit and payment instructions are... (not yet available... soon!).

You are responsible to have a valid passport that does not expire within the next six (6) months from the beginning of the trip.


Please fill out the form and submit...

Welcome to the adventure! Once we receive your trip deposit - or full payment - we will be in touch with you via email to confirm receipt of your funds. If you have paid in full.... Great! You're all set! If not, be sure to keep in mind we will need this paid in full 45 days before the beginning of the trip.

Questions? Let us know! Use the contact form >here<

We want to make sure you are completely informed and aware of everything you should know.Or, answer ANY questions you have about this trip.