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Online Registration

You are registering for:

Program:
Insight Meditation (Vipassana) Retreat
Dates:
September 19-21
Presenter:
James Baraz with Kate Janke

Registrant Information
  1. * Gender:

  2. Defaults to USA
  3. At least one phone number is required
  4. Repeated to be sure it is right
Continuing Education Credits
  1. If you are a nurse and wish to receive a CEU certificate

    Like this: RN98765.
    If you only want a certificate of completion enter COMP for the license #.
Housing Choice


  1. 1st 2nd Housing Cost
    Commuting $214
    Own Van $242
    Own Tent $242
    Center Tent $256
    Dormitory $296
    Triple $318
    Double $338
    Double w/ Bath $362
    Single $400
    Single w/ Bath $450

    If you have a physical disability that limits where you can be housed, please note this in “Additional Requests” below.

  2. If given a choice, would you prefer a cabin or a room?
    What's the difference?

  3. If you wish to share your housing with someone, put their name here:

    1. ← Make sure that they register separately.
Preferences
  1. Carpooling

    1. Privacy Concerns?
    2. Another option is to pay for a ride from an MMC staff member.
  2. How did you first hear about this program?

  3. Shall we keep you informed of events at Mount Madonna Center?

    1. What is MMI?

Please contact me regarding
massage or other bodywork during my stay.

Would you like to contribute to our
Green Fund?

Green Funds will be used for sustainable innovations and eco-events at MMC.

Additional Requests

Include the following in your additional requests:

  • The ages of children you are bringing, if any. Children under 2 are free; between the ages of 2 and 12 are half-price; age 13 and older, please register him/her separately, as an adult.
  • Arrival and/or departure dates if they differ from your program's.

Important Notes

  • Balance is due on arrival (Visa, MasterCard, cash or check only).
  • CANCELLATION or CHANGE in REGISTRATION
    Deposits are non-refundable and are not transferable to another person. For cancellations received at least 2 weeks before the program starts, the deposit less a $50 fee will be credited to any other program within one year. No credit is available for cancellations less than two weeks prior to the program start date, for no-shows, or for leaving an event early. Housing changes incur a $20 change fee.

  • This form does not automatically reserve your spot for the program. You are not registered until we receive your deposit. If the program is full, your deposit will be refunded.
  • Housing is not always available. Do not finalize your travel plans until you have received a housing confirmation from Mount Madonna Center.
  • We will be sending you a confirmation email. Don't let it end up in your spam folder. Add the following addresses to your list of acceptable emails: reservations@mountmadonna.org and programs@mountmadonna.org.