Rains Retreat Dorm Space - Make reservation

Deer Park Monastery » Rains Retreat Dorm Space » Make reservation

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Reservation details

Resource*

Arrival Date*

Registration Rate Selection*
Please select your registration rate from the following options. The Supporter Rate is $13,500 total. The Benefactor Rate is $10,800 total. The Base Rate is $9,000 total. The Reduced Rate is $6,750 total. The Special Case Rate for people 18-35 years old is $4,500 total.
Retreatant First Name*
Retreatant Last Name*
Retreatant Age*
Retreatant Date of Birth*
mm/dd/yyyy (four-digit year)
Retreatant Gender*
Retreatant First Language*
Retreatant Second Language
Sangha or Group
If you attend a Sangha or meditation group, please write the name of the group in the space provided.
Reasons for Attending Retreat*
In 3-5 sentences, please explain your reasons for wanting to attend the full 3 months of the Rains Retreat.

Medical Information

Allergies
Please describe any allergies you may have.
Physical Health History
Please describe any on-going medical conditions you may have and any medications you take for your physical health.
Mental Health History
If you have been diagnosed with a psychiatric or psychological condition, please explain and list any medications you take for mental health.
Doctor's Name
Doctor's Telephone Number
Liability Waiver*
By checking the box above, I and all parties on this registration relieve Deer Park Monastery from all liabilities in the event of any injury or illness incurred while visiting Deer Park Monastery.

Mindfulness Trainings

Have you received the 5 or 14 Mindfulness Trainings?
Dharma Name
If you have been given a Dharma or lineage name, please enter it here.

Billing Details

First name*
Last name*
Address*
City*
ZIP/Postal code*
State/Province*
State / Province
Country*
Email address*
Type your email address again*
Phone*+1
Mobile+1

Emergency Contact

Name of Contact*
Please enter the name of someone other than yourself who can be reached if there is an emergency during your stay.
Relation to you*
Telephone Number of Contact*
Language of Contact

Additional info

I agree to the Cancellation Policy*
For cancellations made prior to arrival day, partial refunds will be available with a cancellation fee of $140 for adults, and $70 for teens and children 6 years and older. Cancellations made on or after the retreat arrival day do not qualify for a refund. Registration is non-transferable.
Retreat Participation Policy*
By checking this box, I acknowledge that I am applying to register for a mindfulness retreat. If accepted, I understand that I am expected to participate in the daily retreat schedule of the monastery and to practice according to the Five Mindfulness Trainings during my stay (the trainings can be found on "The Mindfulness Trainings" page of our website). I also understand that I am expected to remain on the monastery grounds for the duration of my retreat, unless I receive permission to leave and entry information to reenter. Further, I understand that, except in cases of emergency, I will not have access to monastery phones or computers, and that outside work, school, and family obligations must be set aside during my stay.
May we keep in contact?*
Please click on the drop-down arrow to select yes or no. We would like to keep in touch with you, to nourish you with news about the Plum Village tradition practice and community. We will keep your information safe and secure and we won’t share it with other organizations. You will always be able to unsubscribe easily through a link at the bottom of our e-mails. For further details on how your data are used and stored, please visit: https://deerparkmonastery.org/privacy-policy/
Retreat at Monastery
Is this your first time attending a retreat at this monastery or any other monastery founded by Thich Nhat Hanh?
Notes
Enter additional notes here.

Special registration code
If you have received a special registration code from the office, enter it here.

* - required field