Module 2: Paramitas

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* These fields are required

1 Welcome

2 Pricing

3 People in your group

4 Participant Info

Phone *
Address
Address 2
City
State/Prov.
Zip/Postal
Country
Emergency Contact Name and Phone Number *	Please do not use your own name as an emergency contact
Comments *	Please let us know any special circumstances or needs you may have that have not been covered elsewhere
Would you be interested in serving as a Zoom host? *	Yes, and I have experience! Yes, and I will need training No
I consent to Dorje Denma Ling using my image and likeness in photos or videos for its website, social media, and promotional materials. *	Yes No
Can we share your email with other participants and the teacher?	Yes, I give permission to share my email.
CANCELLATION POLICY *	I have read and accept the Cancellation Policy CLICK THE LINK TO VIEW 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 ACCES 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 offence, 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 offence.
NEWSLETTER SIGN-UP	Please email me the Dorje Denma LIng newsletter.

5 Scholarship & Volunteer (Optional)

6 Option to donate to Dorje Denma Ling-- Thank you!

7 Payment

IMPORTANT INSTRUCTIONS IF YOU ARE USING FIREFOX: When navigating to the credit card number, expiration date, and security code fields... you must tab twice or click twice on the fields in order to activate them and be able to enter your data. We are working to resolve this issue.