General Information

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General Information

Please fill out the form below. Your electronic signature at the end of this form completes the waiver.

电子邮件地址 *

Full Name *

Pronouns

Date of Birth *

年

月

日

Mailing Address *

Email Address *

Phone Number *

Emergency Contact: Name & Phone Number *

How did you hear about this retreat? *

Please describe your familiarity with meditation and meditation practice history, and experience with nature-based contemplation. *

What is your meditation retreat history?

This is my first retreat (daylong or residential.)

I've done one or more daylong retreats.

I've attended 1-2 residential retreats in the past.

I've attended 3 or more residential retreats in the past.

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