Volunteering
Flexible Dates
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Welcome
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Participant Information
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Food Allergies
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None
Soy
Milk and Dairy
Peanuts
Tree Nuts
Wheat
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.
Food Allergies- Multiple Items or Other
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Please list any other allergies needs.
Emergency Contact Name
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Emergency Contact Phone
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Relationship to emergency contact
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Spouse/Partner
Parent
Friend
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4
Practice History and Motivation
Do you have previous experience with meditation?
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Yes
No
How many years have you been practicing meditation?
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Zero, I am new to meditation.
Less than one
One to three
Over three
From where did you learn meditation? Which tradition was it in?
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Who is your main practice teacher?
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Type "None" if you do not practice with a regular teacher.
What is your current method of meditation?
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Relaxation
Counting or Following the Breaths
Reciting the Buddha's Name
Silent Illumination
Huatou
Other
Current method of meditation - Other
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How often do you practice meditation?
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Daily
Weekly
Irregularly
Never
Do you encounter any difficulty in your meditation practice?
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No
Yes, please specify.
Explain your meditation difficulty
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Have you participated in a silent meditation retreat before (at DDRC or at another location)?
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No
Yes
When was your most recent silent retreat? Where was it held?
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Have you attended any retreats at DDRC before?
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No, this is my first time attending a retreat at DDRC.
Yes, I have attended a previous retreat at DDRC.
Yes, but I have only attended virtual retreats, not in person.
I do not remember.
The duration of your longest retreat?
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1 day
2-4 days
5-10 days
11 days or more
Please specify the days:
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What motivated you to attend this retreat? What are you looking to get from this retreat?
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How did you hear about us?
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Friends / Family
Email / Newsletter
Internet Search
DDRC website
GMCNY.org
Social Media (FB/instagram)
Other
How did you hear about us- Other
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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.
Physical Demands of this retreat
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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
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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.
Anything else you'd like to add?
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