Life in a Retreat Center

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1 Welcome

2 Participant Information

Phone *
Gender *
Birth Date *	This program is restricted to participants aged 18 and over. By submitting this form, you confirm that you meet this age requirement.
Occupation *
Occupation- Other *
Address *
Address 2
City *
State/Prov. *
Zip/Postal *
Country *
Food Allergies *	If you have any additional dietary needs, please add them in the 'Anything else you'd like to add?' section at the end of the form.
Emergency Contact Name *
Emergency Contact Phone *
Relationship to emergency contact *
Photo *	Send your photo to register@dharmadrumretreat.org after submitting your application.We kindly request that each participant provide us with a photo to help us identify and remember everyone during the retreat, especially during interviews. Your photo will only be used internally and will be kept private and secure.
Email newsletter	Please send me newsletter

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3 What to Know Before You Register

I Agree *	Participants are required to arrive on time and stay for the entire duration of the retreat. Early departures and late arrivals are not permitted.
I Agree *	All participants are expected to follow the retreat schedule and attend all scheduled sessions. Non-participation in any sessions is not permitted.
I Agree *	In order to fully immerse in the retreat experience, we request that participants refrain from making calls, sending messages, or using any electronic devices during the retreat.During the entire duration of the retreat, participants are not allowed to use their phones. However, in case of an emergency, participants' families may contact our phone line at (845) 744-8114. We will ensure that emergency messages are promptly delivered to participants.

4 Practice History and Motivation

Do you have previous experience with meditation? *
How many years have you been practicing meditation? *
From where did you learn meditation? Which tradition was it in? *
Who is your main practice teacher? *	Type "None" if you do not practice with a regular teacher.
What is your current method of meditation? *
Current method of meditation - Other *
How often do you practice meditation? *
Do you encounter any difficulty in your meditation practice? *
Explain your meditation difficulty *
Have you participated in a silent meditation retreat before (at DDRC or at another location)? *
When was your most recent silent retreat? Where was it held? *
Have you attended any retreats at DDRC before? *
The duration of your longest retreat? *
Please specify the days: *
What motivated you to attend this retreat? What are you looking to get from this retreat? *
How did you hear about us? *	Friends / Family Email / Newsletter Internet Search DDRC website GMCNY.org Social Media (FB/instagram) Other
How did you hear about us- Other *

5 Doing a Retreat at DDRC

You may modify your retreat preferences in the "Doing a Retreat at DDRC" section up to 10 days prior to the start of your retreat. An email link will be sent to you after submitting your application to update your preferences at a later time.

Do you need a chair for this retreat? *
Dietary Fasting for Dinner	I would like to fast for dinner during this retreat.
Transportation *	If there is sufficient interest in shuttle service for this event, we will inform those who indicate they are interested in using the shuttle to travel between DDRC and New York City. If you are able to offer or are in search of a shared ride, please join our Discord channel for carpooling arrangements. You will receive the invitation link through the registration notification.
Where are you traveling from and how many seats are available in your vehicle? *
Where are you traveling from? *
Chartered Shuttle Costs	NYC to DDRC - $75 DDRC to NYC - $75 You do not need to pay now, we will add this charge once the shuttle has been confirmed.
Bedding	I would like to reserve bedding (sheets, pillow case, comforter) for the price of $15.Please only reserve bedding if you are traveling a long distance or need to pack lightly.
Physical Demands of this retreat *	I have no concerns regarding my ability to meet the physical demands of this retreat.We warmly welcome you to our retreat center where we offer meditation and an opportunity to practice with us. We strive to provide a safe and comfortable environment for all of our participants. If you have a disability or chronic health issue, please contact us before registering for our events. We are here to address any questions or provide additional information to help you make an informed decision, as we may not have all the necessary resources to meet your needs. Your safety and well-being are our top priority, and we want to ensure that you have a positive and fulfilling experience.
Mental Demands of this retreat *	I have no concerns regarding my ability to meet the mental demands of this retreat.We understand that meditation retreats can be emotionally and mentally challenging, and we want to ensure that all participants have a safe and supportive experience. If you have any concerns or conditions related to mental health, please contact us before registering. Please note that our retreats are not designed to provide professional mental health support. To help us ensure your well-being during the retreat, we kindly ask that you affirm your mental readiness for the challenges of the retreat.
Terms of Agreement *	If I fail to adhere to any of the Retreat Guideline, I acknowledge that I will be asked to leave the retreat without refund and I may not be able to join in any future events.Please carefully read the Retreat Guidelines and Covid requirements. To ensure a meaningful and harmonious retreat experience, it's important to follow our Retreat Guidelines. By submitting this form, I acknowledge that I have read and agree to abide by the Retreat Guidelines. I understand that these guidelines are in place to create a supportive and peaceful environment for meditation practice and community living. I understand that failure to adhere to the Retreat Guidelines may result in my dismissal from the retreat without a refund, and may affect my eligibility to participate in future retreats. Thank you for your commitment to creating a supportive and enriching retreat experience.
Photograph Consent *	Photos and/or video taken on this retreat may be published to our website, social media, or other material. I consent for images and/or videos of me to be used for marketing and/or promotional purposes.

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6 Tell Us More About Yourself

Understanding Your Motivations	We would like to know more about what interests you in Buddhism and why you have chosen to attend our 'Life in a Retreat Center' event. As a Buddhism center, we incorporate Buddhist practices such as chanting, offering, and meditation into our daily life, even during work period and meal time. How does the integration of these practices into daily life appeal to you, and what draws you to Buddhism as a spiritual path?
Your opinions *
Exploring Personal Growth	Our 'Life in a Retreat Center' program is designed for people who are interested in deepening their mindfulness practice and exploring their inner selves. As a participant, you will follow a residency schedule that includes daily meditation and adhering to a set of guidelines during your stay. What inspired you to apply for this program at Dharma Drum Retreat Center, and how do you think this experience will benefit your personal growth and development?
Your thoughts *
Anything else you'd like to add?

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

Thank you for submitting your application. Please note that a registration email will be sent to you shortly. If you don’t receive the email within 10 minutes, please check your Spam mailbox as it may have been filtered there. If you still can't find the email, please contact the appropriate email address for assistances:

Retreat applications: register@dharmadrumretreat.org
Volunteer applications: volunteer@dharmadrumretreat.org

Dharma Drum Retreat Center
184 Quannacut Road, 
Pine Bush, NY 12566
https://dharmadrumretreat.org

1 Welcome

2 Participant Information

3 What to Know Before You Register

4 Practice History and Motivation

5 Doing a Retreat at DDRC

6 Tell Us More About Yourself

7 Payment