[Online] Shambhala Terma Review

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1 Welcome

2 Pricing

	CAD $398.00 – I can offer the suggested amount
	CAD $54.00 to CAD $216.00 – Sliding Scale
	CAD $ Please enter an amount *

3 People in your group

4 Participant Info

Do you have the requirements to take this course? *	I have attended Warriors Assembly I qualify to attend Warriors Assembly, but haven't had the opportunity If you don't know, please reach out to kalapastudygroup@gmail.com
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 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
Can we share your email with other participants and the teacher?	Yes, I give permission to share my email.
May DDL share photos or videos that include you for promotional purposes? (You may withdraw your consent at any time by contacting us.) *	I am happy for photos or videos that include me to be used to share and promote future retreats (e.g., website, social media, print). I prefer not to have my image used for promotional purposes
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 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.
Are you 30 or under?	Yes No By Selecting Yes, you confirm that you are 30 or under at the start of the program.
Input the code 30ANDUNDER at checkout and receive a 25% discount on program fee and meals.
Are you a monastic?	Yes No
Input the code MONASTIC at checkout to receive an 80% discount on program fee and meals.

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5 Donation Options

CAD $	Donation for Dorje Denma Ling Thank you for supporting your practice center!
CAD $	Donation to our Scholarship Fund Your generosity will help participants attend a retreat they may not be able to otherwise.
CAD $	Help Support Solar Sustainability at Dorje Denma Ling

6 Security Check

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7 Payment

Discount Code

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!
3% Option to pay credit card fees	$0

Sub Total	$0

Donations	$0

Taxes	$0

25% Deposit	$0
	$0 next payment date * last payment amount will be $0

Pay	Choose to pay a deposit or the full amount right now.

Due Now	$0 $0

Remaining Balance	$0

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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*