Individual Registration

Abiding Mindfully in the Body: Meditation and Yoga Retreat

First Name *

Last Name *

Street Address *

City *

Zip *

Country *

Province *

Home Phone *

Cell Phone

Email *

Confirm Email *

Personal Information

This information helps us make your retreat experience as smooth as possible.

In-Person Retreat Covid-19 Safety *

I read and understand the In-Person Retreat Covid-19 Safety Measures.

Year of Birth (YYYY) *

Gender *

Male

Female

Transgender or gender diverse (e.g. gender fluid, gender queer, agender)

Meals will be vegetarian with dairy and eggs. We cannot always accommodate special needs. If you have any special dietary needs for health reasons, please explain here.

Special Dietary Needs

Dairy Free

Gluten Free

Other

Please explain your special dietary needs

Residential Insight Meditation meditation retreat experience *

New to residential Insight Meditation retreat

I’ve attended 1-3 residential retreats

I’ve attended 4-10 residential retreats

I’ve attended 10+ residential retreats

Emergency contact

Please provide the name and phone number of someone who is not attending the retreat with you and can assist you in case of an emergency. This information is required for your safety and will only be used in emergencies.

Emergency contact name (Please include the name of someone who will be available during your retreat/program) *

Emergency contact relationship *

Emergency contact phone (Please include the best number to reach your emergency contact person while you are on retreat or participating in our program) *

Black, Indigenous and People of Colour

As part of TNI's commitment to diversity and equity, we have the intention to increase the participation of BIPOC participants in our retreats. To help bring this to fruition, we are holding a portion of all retreat spaces for BIPOC participants. Unused reserved spaces will be released one month prior to the start date of the retreat.

So we can support your participation in the retreat of your choice, please make us aware if you self-identify as Black, Indigenous, or a Person of Color *

Yes

Decline to state

LGBTQIA+

Do you self-identify as LGBTQIA+? *

Yes

Decline to state

Ride Share

Ride-sharing is a great way to simplify retreat transportation while being conscious of our impact on the environment. Note: this information will be posted on a rideshare page available to anyone confirmed for the retreat.

Would you like to participate in ride-sharing? *

Yes

I can offer a ride to *

From where will you be travelling? *

Retreat Fees

Our retreat fees are on a sliding scale basis that allows participants to pay according to individual means. Fees do not include compensation for teachers, who rely on the generosity of retreatants for a sustainable income. There is an opportunity to offer dana (donations) to the teachers at the end of each retreat.

Scholarships are awarded on the basis of financial need only and offer half off the base rate. Scholarships are awarded on a first come, first served basis. We are only able to offer partial scholarships, and must restrict scholarships to one per person, per year; only a limited number of scholarships are available for each retreat. Once all scholarship spots for a retreat are filled, the option will no longer appear on the registration form.

Sliding scale amount you will pay? *

Benefactor - $1700

Sustaining - $1360

Base - $920

Reduced - $740

Scholarship

* Note that a minimum deposit payment of $460 is required to register for this retreat.

CANCELLATION FEES

If you cancel 4 or more weeks before a retreat begins, your deposit is refunded, less a $50 fee.
If you cancel less than 4 weeks before a retreat begins, your deposit is not refunded.

Payment

Please specify the payment method you wish to use *

Online with Paypal

Interac e-transfer

Check

Payment Information

Amount

Deposit Amount

Payment Type

Payment Method

Pay offline

Terms and Conditions *

By registering for this event, I accept Terms and Conditions