2020 Four-Day Retreat Led By Gilbert Gutierrez
Teacher: Gilbert Gutierrez - Dharma Heir of Chan Master Sheng Yen

Gilbert Gutierrez has over forty years of meditation experience, which includes his study of various martial arts as well as Chi Gong. In 2002, he received Dharma Transmission from Chan Master Sheng Yen, making him the only western lineage holder currently residing in the United States. He conducts retreats and lectures throughout North America.  Gilbert teaches in a classical Chan style which inspires his students to investigate Chan through diligent practice.

Begins: Friday, Feb 14, 2020 check-in 4:00-6:00pm
Ends: Monday, Feb 17, 2020 2:00pm

Place:
Mercy By The Sea Retreat and Conference Center (Founders Hall)
167 Neck Road, Madison, CT 06443

Fees:  $350 (Financial Aid is available for those in need.)

Openings: Available - register online
Deadline: Feb 1, 2020

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Vegetarian (not vegan) meals will be served in this retreat. Do you have any dietary restrictions or food allergies?  
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TRANSPORTATION
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FEES
$350 -  Financial aid is available for those in need.

Payment instruction will be sent out when your application is accepted.

As total cost of the retreat is higher than charged price, donation will be greatly appreciated!  
MEDICAL CONDITION
We request the following information to help us determine whether or not participation in a retreat will aggravate a serious medical condition, endanger a participant's health, or disrupt the functioning of a retreat. Please assist us by providing complete and current information on all applicable categories. The information provided will be kept strictly confidential to protect the applicant's privacy.

If you have had serious back or leg ailments, symptoms of headache, dizziness, palpitation, or shortness of breath due to meditation, high or low blood pressure, heart problem, major surgery, allergy, infectious disease, or if you have been treated for serious emotional or psychological symptoms, please briefly state the nature of each problem and the current condition:

SIGNATURE
By signing below, I testify that all the information I have provided is correct and complete. I understand that if I withhold any necessary information, I may be excluded from future participation. If I am accepted, I agree to finish the entire event. I understand that if I leave the event without permission, my application to future events may not be accepted. I agree to relieve Dharma Drum Mountain Hartford CT from all liabilities in the event of any injury or illness incurred while I am on the retreat center property.
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