Notification List for 2027 A Year To Live

* These fields are required

1 Welcome!

3 Practitioner Details

Phone *
Preferred or Chosen Name	We want to be respectful in addressing you. Complete if different from legal name; leave blank if not.
What are your pronouns?
Address line 1 *
Address line 2
City *
State/Province *	This list includes US and Canada, States/Provinces. For all other countries, please select "Other" at the end of this list and then select your country below.
Zip/postal code *
Country *
Birth date *	We ask this for validating your account, for emergency purposes, and rooming for residential retreats. We do not share this information outside of our organization.
YTL: How many daylongs / residential retreats have you attended? *	(estimated number only)
YTL: Please very briefly, state your current meditation practice and when you began your practice. *	(e.g.: “I’ve been meditating [chanting, etc] once a ____ for ____ minutes since ____ [year began].)
Have you taken a previous Year to Live course at Spirit Rock? *	Yes No
YTL: Were you wait listed (did not get in) the last year or two? *	Yes No
YTL: Do you currently have a life threatening prognosis? *	Yes No
YTL: Do you anticipate needing a scholarship rate? *	Yes No
YTL: Which scholarship rate(s) make it possible for you to participate?	Scholarship Rate 1 - $750; Mudita/Karuna Scholarship Rate - $500; BIPOC Scholarship Rate - $500 - please note that we cannot guarantee we can honor all requests.
By joining this list, you’re also agreeing to join our email list. *	I AGREE to join your email list.Uncheck the box if you do not wish to join our email list.
YTL: Class Agreements & Commitments - Important!	Engaging in the content of this course may be uncomfortable, challenging, and/or difficult at times (it can also be profoundly liberating!). To get the most out of this program, we ask that you read thoroughly and commit to the following agreements: 1. I commit to attending ONE of the Program Orientation sessions. 2. I commit to attending the Community Essentials session. 3. I commit to attending a minimum of 10 of the 12 large group sessions live, including the first session, which is REQUIRED. 4. I commit to meeting with my Home Group each month for ~1 hour in between large group sessions. 5. I commit to a consistent meditation or stress management / self-regulation / centering type of practice (preferably daily) for the duration of the program. 6. I commit to do my best to skillfully engage in all sessions (home groups, large groups, breakout groups).
By checking this box *	I AGREE and COMMIT to the Requirements and Agreements.

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4 Demographics

Current age *
Gender *
How do you self-identify your gender?
Do you self-identify as BIPOC? *	Yes-BIPOC No-BIPOC Decline to state-BIPOC
Describe your ethnic origin or background *	Type N/A, if decline to state.
Do you self-identify as LGBTQIA+? *	Yes-LGBTQIA+ No-LGBTQIA+ Decline to state-LGBTQIA+

Notification List for 2027 A Year To Live

1 Welcome!

2 Additional Programs

Participants

3 Practitioner Details

4 Demographics