Registration - Step 1

Program Information

You are registering for:

Program:: Shivaratri Retreat 2023
Dates:: February 17-19

The housing prices below are the total charges for lodging, meals, and use of the facilities.
A tuition charge of $200 is included in the total fees.

	Closer to the start date of the retreat, you will receive a packet of information with schedule and details about the program.

We invite you to stay an additional overnight on Sunday, February 19. You will receive a 20% discount on the room of your choice (depending on availability) for this third night. Please make a note in the Additional Comments field below, and the programs office will contact you with more information. Alternatively, you may email programs@mountmadonna.org or call (408) 846-4090 to add an overnight stay.

Registrant Information

* First Name:
* Last Name:
Alternate Name:

* Gender Identity
(for housing purposes):

Woman
Man
Transgender
Non-binary/non-conforming
Prefer not to respond
How does my choice affect my housing?

* Preferred Pronouns:
Why pronouns matter
* Street Line 1:
Street Line 2:
* City:
* State/Province:
* Zip/Postal Code:
Country: Defaults to USA
* Telephone:
* Email:
* Email Again: Repeated to be sure it is right
Car License: If you are driving to MMC.

Housing Choice

Indicate your first and second choices for housing.
We will do our best to honor your choices. If neither is available, we will assign the next best option, and waitlist you.
Prices are the total charge including meals, lodging, and use of facilities.
A tuition charge of $200 is included in the total fees.
Camp sites are walk-in style with parking nearby.
If you have a physical disability that limits where you can be housed, please note this in “Additional Requests” below.
All individuals must be registered separately.

1st	2nd	Housing	Cost
		Single Cottage 1	$900
		Single w/ Bath	$736
		Single Cottage 2	$710
		Double Cottage 1	$700
		Single	$630
		Double w/ Bath	$588
		Single in Cabin	$572
		Double Cottage 2	$570
		Double	$526
		Double in Cabin	$510
		Triple	$462
		Own Van	$364
		Own Tent	$364
		Commuting	$338

If you are sharing your housing with someone, put their name here:

First Make sure that they register separately.
Last

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

Cabin - heat and electricity, but no indoor plumbing
Room

Gift Card

Gift Card code for Payment

Dietary Restrictions

Please note any dietary restrictions you have such as vegan, gluten free, allergies, etc:

Additional Requests

Include the following in your additional requests:

Arrival and/or departure dates if they differ from your program's.
The ages and names of children you are bringing, if any. Children 4 years and under are welcome free of charge; for 5-12 years old, fees are discounted 50%. Please register children 13 years and older separately as an adult.

Important Notes

Cancellations made at least 2 weeks before your reservation date are fully refundable. Cancellations made 2 weeks to 48 hours prior to arrival date will be charged a $50 processing fee and the remaining payment will be held as a credit toward a future personal retreat or program. There are no refunds for cancellations made less than 48 hours prior to your reservation date.
This form does not automatically reserve your spot for the program. 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: programs@mountmadonna.org.