Karma Triyana Dharmachakra (original) (raw)

NEXT AVAILABLE PERSONAL RETREAT DATE IS October 23, 2024

Please make sure the arrival date on application is no earlier than 10/23/24

If you would like to attend any of our teachings or pujas please visit our Current Calendar to register.

Personal Retreat Application

Please complete and submit the application below.
You will receive an email confirmation.

First Name:

Last Name:

Email:

Phone:

Arrival Date:

Departure Date:

Select Prefered Room Type

Private - $96 per night

Share with Friend - $62 per person / per night

Dorm - $48 per night

Gender (needed for dorm sharing)

female

male

Purpose for Retreat:

In a few words please state your purpose for requesting a personal retreat.
This information will help our Lamas make a determination during the approval process.

List Practices:

Please list any Buddhist practices you do regularly, or ones you are interested in learning.
If none, please state such.

Emergency Contact:

Please provide in case of an accident.

Full Name:

Email:

Phone:

As retreatants stay onsite with our residential community, as well as with other guests, it is necessary we ask the following questions.

Health Considerations:

Do you have any physical / mental health issues that could hinder your retreat experience? If so, please briefly describe. Please also describe your plan for handling this during retreat. If you have no health issues you feel KTD should be aware of please enter, "none".

Do you suffer from substance (drugs/alcohol) abuse?

Yes

If Yes, Please Explain:

Please briefly explain substance abuse issues, including how you plan to work with this during your retreat.

Have you ever been convicted of a felony or placed on probation?

Yes