Program Information

[% IF pr %] You are registering for a Personal Retreat.

$pr_dates [% IF outdoors %]

Outdoor housing only. [% END %] [% IF no_center_tents %]

Center tents are not available. [% END %]

[% ELSE %] You are registering for:
[% IF two_pics %]

[% ELSIF one_pic %]

[% END %]

Program:: $title
Dates:: $dates
Presenter:: $leader_names

[% END %]

COVID-19 Vaccination

Due to the current escalation in cases of Covid-19 nationwide, we have determined the most responsible thing for the safety of all residents and guests is that everyone coming to MMC must be fully vaccinated.

Please take a picture of your vaccination card and upload it here:

If you already uploaded your card click here:

Registrant Information

* First Name:
* Last Name:
Alternate Name:

* Gender:

Female
Male
Non-Binary

* 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

If you have a physical disability that limits where you can be housed, please note this in “Additional Requests” below. [% END %] [% IF ! staff_housing && ! housing_not_needed %]

Housing Choice

$dncc_why * Please indicate your first and second choices for housing:

We will do our best to honor your first and second preferences. If neither is available, we will assign the next best option, and waitlist you for your choices. [% IF pr %]

Prices are per person per day and include meals, lodging, and use of facilities.
All individuals must be registered separately. [% END %]

[% IF ! do_not_compute_costs %] [% IF basicfull %] [% ELSIF next_hc %] [% ELSE %] [% END %] [% END %] $housing_fees

1st	2nd	Housing	Cost for $bdays days	Cost for $fdays days	Cost through $through_date	Cost on and after $next_date	Cost

[% IF covid_vax %] COVID-19 Notice: Double rooms will only be booked for those registering as cohorts. Cohorts are couples or partners who currently cohabitate and therefore feel their health is not at risk by sharing a bedroom together. [% END %]

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

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

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

First Make sure that they register separately.
Last

Additional Requests

[% IF ! housing_not_needed %] [% IF ! pr || children_welcom %] Include the following in your additional requests: [% END %]

Arrival and/or departure dates if they differ from your program's. [% END %] [% IF children_welcome %]
The ages and names 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. [% END %]

[% END %]

Important Notes

This program is for adults only - please do not bring your children. [% END %] [% IF ! collect_total %]
Balance is due on arrival (Visa, MasterCard, cash or check only).
$canpol
This form does not automatically reserve your spot for the program. [% IF ! collect_total %] You are not registered until we receive your deposit. [% END %] 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 notifications@mountmadonna.org.

Registration - Step 1

Program Information

COVID-19 Vaccination

Registrant Information

Continuing Education Credits

Housing Choice

Housing Choice

Donation

Gift Card

Preferences

Additional Requests

Important Notes