Register

Application for Personal Retreat, Crestone, CO, USA

Open Dates

* These fields are required

1 Retreat Application

First Name *
Last Name *
Email *
Phone *
Cell Phone Number *
Address *
Address 2
City *
State/Prov. *
Zip/Postal *
Country *
Emergency Contact Name and Number *	Please enter the name and contact information of someone we can contact for you in case of an emergency.
Comments or Special Needs
Select a preferred check-in date. NOTE: check-in must be on a Saturday. *
Select a preferred check-out date for you retreat. NOTE: Check-out must be on a Saturday. Maximum duration of retreats is currently twelve weeks. Minimum is one week. *

2 PERSONAL INFORMATION

Briefly describe any conditions that may limit your ability to be in retreat. *

3 STUDY AND PRACTICE INFO

Have you received pointing out instructions with Tsoknyi, Mingyur or Tulku Urgyen Rinpoche or another qualified Dzogchen or Vajrayana master? (If not please contact the Registrar before completing the application.) *	Yes No
If you have received pointing out instructions from a Dzogchen/Vajrayana master other than Tsoknyi Rinpoche, please list the name of that teacher. *
Why do you want to do solitary retreat? *
How long have you been practicing dharma? *
List the solitary retreats you have done in past: *
Please tell us a little about your daily personal practice: *

4 RETREAT PLAN

What is your retreat facility preference? Check all that apply. *	Cabin Lama House
Have you ever lived alone where you were completely self-reliant? If so please explain. *
Have you spent time in a relatively remote area for long periods of time? Are you afraid of the dark or wildlife? *
Can you plan your meals so that shopping occurs at most once a week? *
What is the thing that most concerns you about doing this retreat? *
Is there anything else that you would like us to know about you?
Would you object to having gardening or landscaping done outside your cabin or Lama House while you are in retreat? *

5 AGREEMENTS AND WAIVERS

Have you read the Retreat FAQs on the Pundarika Website (Link to FAQs)? *	Yes, I have read the Retreat FAQs on the Pundarika website.
Have you read and do you agree to the terms and conditions of the Retreat Agreement and Waiver and Release documents (Link to "General Waiver and Release")? *	Yes, I have read and I agree to the terms and conditions and understand that I will need to sign a Waiver and Release form after registration.