Community Dharma Leaders Program (CDLT25)

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1 Welcome

2 Price

Confirm the sliding scale rate you agreed to pay below. Do not select any other rate. Amounts paid above the Sustainer rate are a tax deductible donation to Spirit Rock. Your generosity supports Spirit Rock, staff, and your fellow practitioners. Your confirmation email is your tax receipt.

Important Note: Scholarship rates require pre-approval. All scholarship funds have been awarded. Please do not select a scholarship rate if you were not pre-approved.~Thank you!

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Benefactor DTP

The Benefactor rate supports your fellow practitioners; tax-deductible portion is the difference between the Basic rate and this rate.

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$16,475

$16,475

$16,475
Benefactor DTP

The Benefactor rate supports your fellow practitioners; tax-deductible portion is the difference between the Basic rate and this rate.

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Sustainer DTP

The Sustainer rate covers more of the programs costs and supports your fellow practitioners; tax-deductible portion is the difference between...

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$12,875

$12,875

$12,875
Sustainer DTP

The Sustainer rate covers more of the programs costs and supports your fellow practitioners; tax-deductible portion is the difference between the Base rate and this rate.

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Base DTP

The Base rate covers only a small portion of the program cost. Not tax deductible.

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$9,250

$9,250

$9,250
Base DTP

The Base rate covers only a small portion of the program cost. Not tax deductible.

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Reduced Rate DTP

A supported/subsidized rate to enable participation. This is a scholarship rate and is not tax deductible.

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$7,350

$7,350

$7,350
Reduced Rate DTP

A supported/subsidized rate to enable participation. This is a scholarship rate and is not tax deductible.

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Mudita/Karuna Scholarship Rate DTP

The Muditā/Karuṇa Scholarship – includes both types of scholarship. Not tax-deductible. The Muditā Scholarship supports any individual who requires financial...

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$5,450

$5,450

$5,450
Mudita/Karuna Scholarship Rate DTP

The Muditā/Karuṇa Scholarship – includes both types of scholarship. Not tax-deductible. The Muditā Scholarship supports any individual who requires financial support, including our elders (65+) on fixed incomes. The Karuṇa Scholarship is for individuals with serious medical conditions, or life-threatening illnesses who require financial support.

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BIPOC Scholarship Rate DTP

Dr. Marlene Jones People of Color Scholarship is for individuals who self-identify as Black, Indigenous, and/or a Person of color...

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$5,450

$5,450

$5,450
BIPOC Scholarship Rate DTP

Dr. Marlene Jones People of Color Scholarship is for individuals who self-identify as Black, Indigenous, and/or a Person of color and require financial support. Not tax-deductible.

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CANCELLATION FEES If you need to withdraw from the program, the following fee structure will apply.

Full refund: Prior to August 1, 2024
10% fee:* August 1 - September 29, 2024
25% fee:* September 30 - October 31, 2024
50% fee:* November 1 - December 1, 2024
No refunds: On or after December 2, 2024

*Fee deducted from refund; fee is a percentage of the total amount agreed to pay. These fees apply to all participants.

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4 Practitioner Details

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; and for emergency purposes and rooming for in-person programs. We do not share this information outside of our organization.
Emergency contact name *	Please include the name of someone who will be available during your retreat/program. For Residential retreats, if you are traveling from a foreign country, we would prefer that you provide a contact person who is in the United States.
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. This will not be used for anything except to care for you in case of an unexpected crisis or emergency.
Liability Waiver for Participating in In-Person Programs - By checking this box *	I AGREE - I acknowledge that I have read and agree to the terms in this "Liability Waiver"PLEASE READ - LIABILITY WAIVER This document will open as a PDF.

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5 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 Spirit Rock holds the intention to increase participation of Black, Indigenous, and People of color (BIPOC) in our programs. To support this commitment, we prioritize a portion of all retreat spaces for BIPOC community.
Describe your ethnic origin or race *
Do you self-identify as LGBTQIA+? *	Yes-LGBTQIA+ No-LGBTQIA+ Decline to state-LGBTQIA+
How would you describe your sexual orientation?	Optional.

6 Accommodations and Food (CDL & TT)

All attendees will have a single room accommodation.

Preferred gender floor *	No preference All-gender floor Female only floor Male only floor We cannot guarantee we can accommodate all "floor preferences" but we will do our best!
First-floor room needed?	Yes, I have mobility limitations.Only select if you MUST be on a first-floor room. We prioritize first-floor rooms for those with mobility limitations and elders in need.
Describe any serious mobility/physical limits we should be aware of	This includes: if you use a personal wheelchair and/or if you have an ADA certified service dog; if you are DEAF, or have severe Blindness. We would like to connect with you as soon as possible to see how we can support your participation.
Need scooter	Yes, I need to reserve a scooter.We have a maximum of four scooters available per retreat. If you have a serious mobility issue, we recommend that you reserve a scooter.
Chemical sensitivity	Yes, I need to be in a chemically sensitive building.We have one dormitory that has wood flooring and no carpeting throughout the building. If you have allergies or are a chemically sensitive being, we recommend this building for you.
Snore *	No, I don't snore Yes, I snore
CPAP machine	No, I do not use a CPAP machine. Yes, I use a CPAP machine.
Allergies *	No food allergies Yes food allergies FOOD ALLERGIES Spirit Rock serves lacto-ovo-vegetarian meals. We cook with seasonal, organic products whenever possible and source from local farmers and other suppliers for the freshest ingredients available. We have a 'simple foods' table available for those with particular food limitations and every food dish is labeled with the ingredients used so you may use your own discretion. You’ll have an opportunity to let the cooks know about your particular food needs. If 'YES', PLEASE TELL US WHAT THE FOOD ALLERGY IS AND THE LEVEL OF SEVERITY.
What is your food allergy and level of severity?*	*We are NOT able to accommodate extreme dietary preferences. However, if you have a LIFE-THREATENING ALLERGY (eg. peanut) we should have a conversation with you before you attend a retreat here. Please contact the Registration Department as soon as possible.
Dietary Retrictions	Vegan Gluten Free Check all that apply.

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New to Spirit Rock? *	Yes-new to Spirit Rock No-not new to Spirit Rock
How did you hear about Spirit Rock?
May we share your contact information with the teacher(s) or presenter? *	Yes No
Image Consent	I AGREE - I acknowledge that I have read and agree to the terms in this "Image Consent"PLEASE READ - IMAGE CONSENT: I grant permission to Spirit Rock Meditation Center to take photographs and/or record digital media of me for use in promotional materials. These materials might include printed or digital products. I authorize the use of these images and recordings without compensation to me. All images and recordings shall be the property of Spirit Rock.

1 Welcome

2 Price

Select an option*

Benefactor DTP

Sustainer DTP

Base DTP

Reduced Rate DTP

Mudita/Karuna Scholarship Rate DTP

BIPOC Scholarship Rate DTP

3 Additional Programs

Participants

4 Practitioner Details

5 Demographics

6 Accommodations and Food (CDL & TT)

7 Tell Us More

8 Payment

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