Men's Rite of Fire October 24-26, 2026 - Retreat Application

Thank you for your interest in Men’s Rite of Fire, a three-day masculine initiation retreat held October 24 - 26 in Sedona. This retreat is intentionally small and application-based to preserve depth, safety, and coherence within the group.

The questions that follow are designed to assess readiness, intention, and capacity for embodied group work. Please answer honestly. There are no right or wrong responses.

This retreat is not therapy or crisis support. By submitting this application, you acknowledge that you are emotionally stable, willing to take responsibility for your inner experience, and open to challenge, reflection, and brotherhood.

Retreat Form

First Name *

Last Name *

Email *

Phone *

Age *

What is calling you to this retreat at this moment in your life? *

What do you feel you are being initiated out of, and into? *

What are you hoping to confront, clarify, or embody during this experience? *

How do you typically respond to physical or emotional discomfort? *

Describe a time you stayed present through something difficult rather than avoiding it. *

What practices (if any) do you currently have that support regulation, grounding, or self-reflection? *

What does “brotherhood” mean to you at this stage of your life? *

How do you relate to honest feedback or being witnessed by other men? *

Are you willing to show up with honesty, respect, and confidentiality for the group? *

Yes

Do you have any injuries, medical conditions, or limitations we should be aware of (especially related to hiking, breathwork, or cold exposure)?

Please read the following carefully. As a precaution, care is needed for the following conditions. It is important that you inform your facilitator (Michael Pupiales) if any of the following conditions are relevant to you:

Contraindications for Breathwork:

Acute somatic and viral diseases
Chronic obstructive pulmonary disease (COPD-II and COPD-III)
Chronic diseases with symptoms of decompensation or terminal illness
Individual intolerance of oxygen insufficiency
Cancer
Epilepsy, pacemakers or heart arrhythmias
Pregnancy
Detached Retina
Glaucoma
High Blood Pressure (not controlled with medication)
Cardiovascular disease including angina, previous heart attack or stroke.
Diagnosis of aneurysm in the brain or abdomen
Uncontrolled thyroid conditions and diabetes
Asthma - if you are asthmatic, you are welcome to attend providing you bring your inhaler to the session.
Epilepsy
Prior diagnosis of bipolar disorder, schizophrenia or previous psychiatric condition.
Hospitalization for any psychiatric condition or emotional crisis within the last 10 years.
Any other medical, psychiatric or physical conditions which would impair or affect ability to engage in any activities that involve intense physical and/or emotional release.

Contraindications for Ice Baths:

Coronary heart disease (e.g. Angina Pectoris; Stable Angina)
Cold urticaria
Epilepsy
Kidney failure
Raynaud’s Syndrome (Type II)
High blood pressure (in case of prescription medication)
A history of serious health issues like heart failure or stroke
Very recent operation

Do any of the above contraindications for breathwork or ice baths apply to you? *

Yes

No

Are you willing to participate in ice baths and other physical practices within your own limits? *

Yes

No

Maybe

(Date and Time TBA)

Can you commit to attending 2 pre-retreat and 2 post-retreat Zoom calls? *

Yes

No

Maybe

What day(s) and time window(s) work best for you to attend pre-retreat and post-retreat zoom calls? *

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Why do you feel ready for this initiation now? *

Additional notes

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