Finding Your Stillpoint and Craniosacral Techniques for Your Body, Mind and Spine

GENEROSITY POLICY NOTICE: Donor-supported sliding scale and scholarship options are available. To ask about this or to set up a payment plan, write to finance@dorjedenmaling.com.

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1 Welcome

3 People in your group

4 Participant Info

Phone *
Comments	Please let us know any special circumstances or needs that have not been covered elsewhere
Address
Address 2
City
State/Prov.
Zip/Postal
Country
How did you hear about the retreat ? *
To your knowledge, do you snore?	Yes No
Requested Roommate
Diet *	Gluten Free, Lactose Free, Enter Other Diet Notes in the box below
Please list any food allergies or sensitivities or any notes about diet we should know
Emergency Contact Name and Phone Number	Please do not use your own name as an emergency contact
Medical Issues *	Please note any medical issues or enter "no". If this information pertains to your child, let us know if they have any learning or behavioural challenges.
Drug or Other Medical Allergies *	Enter No if you have no drug or medical allergies. Food allergies should be entered under the Diet Question.
Current Prescriptions and Drug Allergies *	Please list any prescriptions you currently are on and drug allergies we should know about in case of emergency
Please list these, including injuries from the past and present conditions. It will help the teacher and meditation instructors support your physical needs.
In order to support you during your stay, please tell us if you have any mental health challenges we should know about. (Held in strictest confidence.)	Retreat is a powerful practice that can trigger various mental states. It is essential that the teacher and meditation instructors understand your history so that they can support you during the retreat.
Why is it important for you to attend this retreat? How do you hope to benefit from the practice?	Tell us something about your inspiration to practice and study the dharma.
CANCELLATION POLICY *	I have read and accept the Cancellation Policy CLICK THE LINK TO VIEW POLICY
COVID POLICY *	I have read and accept the Covid PolicyCLICK THE LINK ON THE TITLE LABEL TO READ OUR COVID POLICY
LIABILITY WAIVER *	I have read, understand and accept the Liability WaiverI hereby agree to hold harmless Dorje Denma Ling and Shambhala International, its officers, employees and volunteer staff, from and against any and all claims, liability, loss, cost or obligation, which may arise from participating in programs, employment and activities at Dorje Denma Ling.
CODE OF CONDUCT *	I have read, understand, and accept the Shambhala Code of ConductCLICK THE LINK TO ACCESS FULL CODE DETAILS: If I do not comply with these policies, I understand that I will be asked to leave the land, and that, depending on the offense, I could also be referred to either the independent review board for the Shambhala Code of Conduct or, the police, in the case of a legal offense.
NEWSLETTER SIGN-UP	Please email me the Dorje Denma LIng newsletter.
Can we share your email with other participants and the teacher?	Yes, I give permission to share my email.
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5 Donation Options

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6 Security Check

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7 Payment

Option to pay credit card fees	I would like to help offset the fee for using my credit card. Dorje Denma Ling is charged when participants use credit cards. Help us become sustainable!
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	SCHOLARSHIP APPLICANTS: CLICK REGISTER to complete the application/registration process. We will process your application and contact you with the new balance. TO PAY USING E-TRANSFER: 1) be sure to note the name of the program for which you are paying 2) send your e-transfer to finance@dorjedenmaling.org TO PAY BY CHECK: Finance Office Dorje Denma Ling 2280 Balmoral Rd, The Falls, Nova Scotia, B0K1V0, Canada Your registration or donation will be complete once we receive your payment. Click on the button below and these instructions will be repeated on the next page.

	You will be asked for payment details in the next step. Click the button below to continue.

	By submitting payment, you authorise Dorje Denma Ling to send instructions to the financial institution that issued your card to take payments from your card account in accordance with the terms of Dorje Denma Ling's agreement with you.

Guest 1		First Name* Last Name* Email*
Guest 1		First Name* Last Name* Email*

1 Welcome

2 Lodging & Pricing

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Gyatso Lodge: Single Occupancy

Gyatso Lodge: Double Occupancy

Drala Cabin: Single Occupancy

Drala Cabin: Double Occupancy

Wood Cabin: Single Occupancy

Wood Cabin: Double Occupancy

Large White Tent: Single Occupancy

Large White Tent: Double Occupancy

White Hut: Single Occupancy

Bring Your Own Tent: Platform Provided

Shrine Room Floor: Garuda & Dragon

Offsite Lodging

3 People in your group

4 Participant Info

5 Donation Options

6 Security Check

7 Payment