Test Page - Kamentsa Inga Church

By digitally signing this form, I authorize Kamentsa Inga Church, The Soul of the Hummingbird, to take my photograph, video or other digital media (“photo”) in any of its publications, including web-based publications, without payment or other consideration.

By digitally signing this form, that I understand the need and importance to answer the following questions truthfully, as accurately as possible and to the best of my knowledge and hability.

I understand that my responses to the above screening questions determine my eligibility to participate in sacred ceremonies with Kamentsa Inga Church, The Soul of the Hummingbird; and if I am denied participation in a ceremony due to my responses to the above screening questions, such denial is based on a determination that my exclusion is for the safety and benefit of myself and other ceremony participants.

I understand that this membership form is an integral part of Kamentsa Inga Church, The Soul of the Hummingbird Waiver of Liability form.

By digitally signing this form, I represent and warrant that I am of sound mind and body and believe that I am mentally and physically fit to participate in a ceremony with Kamentsa Inga Church, The Soul of the Hummingbird, notwithstanding the determination of its staff regarding my fitness to participate.

By digitally signing this form, declare that in spite the fact that I may have physical and/or mental illnesses, I believe that I am fit normasly to participate in a ceremony with Kamentsa Inga Church The Soul of the Hummingbird. For the healing of these.

By digitally signing this form, I grant Kamentsa Inga Church, The Soul of the Hummingbird, permission to take and publish my photograph, video or other digital media (“photo”) in any and all of its publications, including web-based publications, without payment or other consideration.

I authorize, under my sole responsibility and at my own risk and expense, Kamentsa Inga Church The Soul of the Hummingbird to administer to me its sacred sacrament ayahuasca-yage and the other elements that the church considers necessary for my physical and spiritual healing process.