Qigong and Meditation: Reclaiming Calm, Clarity, and Centered Presence (TJ2D26)

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1 Welcome! Registration for the On-Land (in-person) Retreat

2 Price

Please consider paying at the highest rate that you can afford: your generosity supports teachers as well as Spirit Rock and your fellow practitioners who need to pay less.

Any amount paid above the Sustainer rate is a tax-deductible donation to Spirit Rock. Your confirmation email is your tax receipt.

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Benefactor.

The Benefactor rate covers the cost of the program and supports fellow practitioners; tax-deductible portion is the difference between the...

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$310

$310

$310
Benefactor.
The Benefactor rate covers the cost of the program and supports fellow practitioners; tax-deductible portion is the difference between the Sustainer rate and this rate.

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Sustainer.

The Sustainer rate covers the cost of the program. Not tax-deductible.

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$235

$235

$235
Sustainer.
The Sustainer rate covers the cost of the program. Not tax-deductible.

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Basic.

The Basic rate covers a portion of the cost of the program and is partially subsidized. Not tax-deductible.

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$140

$140

$140
Basic.
The Basic rate covers a portion of the cost of the program and is partially subsidized. Not tax-deductible.

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Mudita/Karuna Scholarship Rate.

Contributing at the Scholarship rate - Muditā/Karuṇa Scholarship: Deeply subsidized rate; does not cover program costs; not tax-deductible; Muditā: supports...

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$70

$70

$70
Mudita/Karuna Scholarship Rate.
Contributing at the Scholarship rate - Muditā/Karuṇa Scholarship:

Deeply subsidized rate; does not cover program costs; not tax-deductible;

Muditā: supports any individual who has significant financial need; this includes our low income folks and elders (65+) on fixed incomes;

Karuṇa: supports individuals who have significant financial need and have a serious medical condition, or life-threatening illness.
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BIPOC Scholarship Rate.

Contributing at the Scholarship rate - Dr. Marlene Jones People of Color Scholarship: Deeply subsidized rate; does not cover program...

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$70

$70

$70
BIPOC Scholarship Rate.
Contributing at the Scholarship rate - Dr. Marlene Jones People of Color Scholarship:

Deeply subsidized rate; does not cover program costs; not tax-deductible;

Supports individuals who have significant financial need and who self-identify as Black, Indigenous, and/or a Person of color (BIPOC).
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Cancellation Policy for On-Land Day Programs:

NO REFUNDS.
Open Credit or Donation to Spirit Rock = if you cancel 2 business days or more prior to program start (Pacific Time)
No Open Credit = if cancel less than 2 business days prior

To request a credit or donate your fees, please email us by the deadline above so we have a record of your cancellation. Credits must be used within one year of their date of issue. Credits cannot be accessed at the door or online.

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4 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.

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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
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+
How would you describe your sexual orientation?	Optional.

6 Tell Us More

Wheelchair	Yes, I use a wheelchair.This information is used solely for the purposes of supporting your attendance. We would be grateful for a conversation with you prior to the program/retreat.
Service dog	Yes, I require a service dog to accompany me in support of my ADA recognized disability.This information is used solely for the purposes of supporting your attendance. We would be grateful for a conversation with you prior to the program/retreat.
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
Liability Waiver for Participating in On-Land 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
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.

7 Payment

Credit Card Fee (non-refundable)	Credit Card Fee Opt-in I agree to cover the credit card processing fees for my registration. I understand that this fee is non-refundable if I should cancel my registration.
3% Credit Card Fee (non-refundable)	$0

Sub Total	$0

Donations	$0

Taxes	$0

50% Deposit	$0

Due Now	$0 $0

	You will be asked for payment details in the next step. Click the button below to continue.

1 Welcome! Registration for the On-Land (in-person) Retreat

2 Price

Select an option*

Benefactor.

Sustainer.

Basic.

Mudita/Karuna Scholarship Rate.

BIPOC Scholarship Rate.

3 Additional Programs

Participants

4 Practitioner Details

5 Demographics

6 Tell Us More

7 Payment