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1.
Add your details
I'm Going
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First name
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Last name
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Email
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Phone Number
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Is this the first time receiving Kambô?
Yes
No
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Please disclose any relevant physical, mental, or emotional health conditions honestly and to the best of your knowledge.
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Please disclose any current medications or supplements honestly and to the best of your knowledge.
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What brings you to Kambô at this time?
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I confirm I have read the contraindication and cautions section info carefully
Yes
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Please confirm one of the following in regards to pregnancy:
I am not pregnant and do not suspect I may be pregnant.
I am pregnant or suspect I may be pregnant.
Not applicable (I am a man).
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I understand that Kambô is not a substitute for medical treatment and is not intended to diagnose, treat, or cure any condition.
Yes
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I understand that this event is not intended to promote any products or services for the diagnosis, treatment, cure, or prevention of any medical condition.
Yes
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I understand that Kambô should not replace advice or treatment provided by a registered health practitioner.
Yes
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I have paid a $60 deposit to account 04-2021-0224619-13 and understand that spaces are limited and not secured without a deposit.
Yes
No
Please add me to the mailing list (for group circle ceremonies info/updates)
Yes
No
Next
2.
Event Policies
Kambo Sacred Ceremony Auckland - September 2026
12 Sept 2026, 10:15 am – 5:00 pm
Wainui Community Hall
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