General Program Registration

Program Name:

First Name	Last Name

Street

City	State	Zip/Postal Code

Country

Email:	Home Phone:	Cell Phone:

Please indicate: Gender

Arrival date:	Departure date:

Do you have any health conditions we should know about?

Any special dietary restrictions?

Medical doctor:	Phone:

Emergency contact person:	Phone:

How long have you studied and/or practiced Buddhism?	What tradition(s)?

Prior retreat experience?

How did you hear about us?

Registration Type: Member or Non-Member

Accomodation request

After completing your registration form and payment in full you will receive a confirmation email. If you do not receive your confirmation within seven days of submitting your registration, please contact Registration at registration@milarepacenter.org or via phone at 1-802-633-4136. Please note a space will not be held for you without a completed registration form, payment in full and receipt of a confirmation letter.

At the end of the retreat, you will have the opportunity to make an offering to the teacher and interpreter in appreciation for receiving teachings on the precious Dharma.

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Pay for Registration

Donations Welcome

Giving charity is an essential component of Buddhist practice. It is through kind generosity that the Dharma flourishes and all favorable conditions can take root. We greatly appreciate your support.

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