Registration For Ancestry in Progress Retreat

 

Ancestry in Progress, Mindfulness Retreat, Oct 25-27 at Chamounix Mansion

This retreat is centered on creating a mindfulness practice retreat space for POC, gender non-conforming/fluid folx, young practitioners, and others on the east coast who are typically marginalized in wellness/spiritual circles. Because of this we are holding the majority of spaces for folx in these intersections.

please fill out the following registration form. once you hit submit you will be taken to a payment page to make a deposit or pay in full. Once you submit your application and make your payment you will be registered!

Name *
Name
Phone *
Phone
Address *
Address
What is your ethnicity/cultural heritage? *
There is room to use your own language below.
What is your gender identity?
There is room to use your own language below.
What is your approximate age?
What privileges does society afford you?
There is room to use your own language below.
Best phone contact info for them: *
Best phone contact info for them:
Meals *
Please let us know if you have any food allergies, needs or preferences:
Do you need a ride or can you offer a ride? Please list if you either need or can offer a ride and from where:
Room Assignments *
All Rooms are shared. We'll do our best to accommodate everyone's needs and preferences. Please check all that apply:
Please list the names of people you'd like to room with:
(Access or functional needs refers to circumstances that are met for providing physical, programmatic, and effective communication access to the whole community by accommodating individual requirements through universal accessibility and/or specific actions or modifications including assistance, accommodation or modification for mobility, communication, transportation, safety, health maintenance, etc.
Have you attended a retreat in the Plum Village / Thich Nhat Hanh tradition in the past? *
Would you like to receive a transmission of the 5 Mindfulness Trainings during this retreat? *
The Five Mindfulness Trainings are based on the precepts developed during the time of the Buddha to be the foundation of practice. They are one of the most concrete ways to practice mindfulness. They are nonsectarian, and their nature is universal. All spiritual traditions have their equivalent to the Five Mindfulness Trainings.
Volunteering: Advanced Prep
If you are interested in volunteering with preparations for the retreat please check all that apply
Volunteering: During the Retreat
If you are interested in volunteering during the retreat please check all that apply
Volunteering: End of Retreat
If you are interested in volunteering at the end of the retreat please check all that apply
Scholarships
We are actively seeking donations to provide scholarships. Funding may be available depending on donations. What we get we'll give! What amount of the retreat fee in scholarship would allow you to attend? * If you wish to donate to the scholarship fund you'll find a link on the payment page, once you submit this form Please indicate your interest below:
 

* Once you click submit you’ll be taken to the payment page to make your deposit or pay in full.

*Your registration will not be considered complete until you make your payment. Thank you so!