Rooted in Love: Heart Qualities and the Living Elements – Annual BIPOC Retreat (242R27)

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1 Welcome

2 Price

Please consider paying at the highest rate that you can afford: your generosity supports Spirit Rock's efforts in offering lower sliding scale rates and supporting the large number of scholarship requests. Registration fees DO NOT include teacher dana. At the end of the retreat, there will be an invitation to offer dana to the teachers and to Spirit Rock.

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

In need of a scholarship? If you need a scholarship to attend, DO NOT continue registering now as this will disqualify you from a scholarship opportunity in this retreat. For more info and how to apply, see our Financial Support FAQ's.

Select an option*

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Supporter-guaranteed single.

Contributing at the Supporter rate: "Generosity brings happiness from the intention, the act, and the memory of giving." - The...

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$3,750

$3,750

$3,750
Supporter-guaranteed single.
Contributing at the Supporter rate: "Generosity brings happiness from the intention, the act, and the memory of giving." - The Buddha;

Covers the full cost of the retreat, accompanied by a deeply generous offering;

Your generosity reverberates through our community, fostering accessibility through reduced rates and scholarships;

Guarantees a single room accommodation;

Your gift is tax deductible (amount above Sustainer rate).
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Benefactor-residential.

Contributing at the Benefactor rate: “The gift of Dharma surpasses all gifts.” – The Buddha; Covers the cost of the...

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$3,000

$3,000

$3,000
Benefactor-residential.
Contributing at the Benefactor rate: “The gift of Dharma surpasses all gifts.” – The Buddha;

Covers the cost of the retreat with a meaningful contribution;

Upholds Spirit Rock programs, nurturing their growth and impact;

High probability of a single room accommodation;

Your gift is tax deductible (amount above Sustainer rate).
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Sustainer-residential.

Contributing at the Sustainer rate: "Generosity is the beginning of awakening." – The Buddha; Covers the cost of the retreat;...

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$2,250

$2,250

$2,250
Sustainer-residential.
Contributing at the Sustainer rate: "Generosity is the beginning of awakening." – The Buddha;

Covers the cost of the retreat; not tax-deductible;

Room assignment may be shared (2-person) or single, depending upon availability.
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Basic Rate-residential.

Contributing at the Basic rate: Covers a portion of the retreat costs; Partially subsidized and not tax deductible; Room assignment...

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$1,500

$1,500

$1,500
Basic Rate-residential.
Contributing at the Basic rate:

Covers a portion of the retreat costs;

Partially subsidized and not tax deductible;

Room assignment may be shared (2-person) or single, depending upon availability.
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Cancellation Policy (Residential Retreats):*

Standard Cancellation Fees:

$50: On or before 12 weeks
$100: 8-12 weeks before
$175: 4-8 weeks before
$300: 2-4 weeks before
No refunds as of 2 weeks before

*Fees reduced for serious illness or death in family

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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.
Meditation Practice Experience-ResRetreats *	New to Vipassana residential retreat practice. I've attended 1-3 residential retreats. I've attended 4-10 residential retreats. I've attended 10+ residential retreats.
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.

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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 Accommodations and Food

All attendees should be prepared for the possibility they will be in a shared accommodation and to "accept what is offered" in the spirit of the Buddhist precepts. We have many more single rooms than double rooms; however, due to the high number of single-room needs, we cannot honor all requests.

Single-room priority is reserved for those with serious medical needs (with a limited number reserved for those selecting the Supporter rate which guarantees a single room, when that rate is available). All remaining rooms will be randomly assigned. We gratefully welcome room-share requests!

Room Assignment Acknowledgement - By checking this box *	I AGREE - In the spirit of the precept of "taking what is offered" I acknowledge and understand that I may be assigned a double or a single room; unless I have selected the Supporter rate which guarantees a single room.
Preferred gender floor *	No preference All-gender floor Female only floor Male only floor THIS IS NOT GUARANTEED. We cannot guarantee we can accommodate all "floor preferences" - rooming is a complicated process.
Requested roommate	Type the name of the person you want to share a room with. Roommates MUST request each other. Please do not fill in with any other room accommodation requests. Type N/A if not applicable.
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. IMPORTANT! PLEASE EMAIL US, prior to registering, especially if this is your first time coming on retreat with us. We would like to connect with you as soon as possible to understand if 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.
Smoke or Vape	Yes, I smoke tobacco products and/or vape.
Chemical sensitivity	Yes, I need to be in a chemically sensitive building.IMPORTANT NOTE: if you require this dorm, we may not be able to also accommodate your floor preference. We have only 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 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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7 Tell Us More

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.

8 Security Check

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9 Payment

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1 Welcome

2 Price

Select an option*

Supporter-guaranteed single.

Benefactor-residential.

Sustainer-residential.

Basic Rate-residential.

3 Additional Programs

Participants

4 Practitioner Details

5 Demographics

6 Accommodations and Food

7 Tell Us More

8 Security Check

9 Payment