Registration - Step 1

Program Information

[% IF mountain_experience %] You are registering for a Mountain Experience.
    Date: ${sdate.format("%A, %B %e, %Y")}

    Meals: $meals
    Activities: $activities [% IF children_name_age %]
    Children: $children_name_age [% END %]

[% ELSIF 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
[% IF leader_names %]
Presenter:
$leader_names
[% END %]
[% END %] [% IF ! housing_not_needed %] [% IF type == 'Total' %]

The housing prices below are the total charges for lodging, meals, and use of the facilities. [% ELSE %]

The housing prices below are Per Person Per Day and include lodging, meals, and use of the facilities. [% END %] [% IF tuition %]
[% IF tuition_rolled %] A $tuition_name charge of \$$tuition is included in the total fees. [% ELSIF basicfull %] A $tuition_name charge of \$$tuition (or \$$full_tuition for $fulldays days) will be added. [% ELSE %] A $tuition_name charge of \$$tuition will be added. [% END %] [% END %] [% END %] [% IF confnote %]

$confnote [% END %] [% IF reg_msg %]

$reg_msg [% END %]

[% IF pr %] [% END %] [% IF basicfull %]
Length of Program

*How many days do you want to attend?

[% ELSE %] [% END %] [% IF covid_vax %]

Covid 19 Protocols

Covid 19 Vaccinations: Proof of full Covid vaccination is required with registration for all guests of MMC. Note that our Covid policies may change between now and the time of your program. We will keep you informed of any such changes.

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

*

[% END %]

Registrant Information

* Gender Identity
(for housing purposes):






  2. How does my choice affect my housing?

  1. Why pronouns matter
  7. Defaults to USA
  10. Repeated to be sure it is right
    11. [% IF ! housing_not_needed %]
  11. If you are driving to MMC.
    12. [% END %]
[% IF ceu %]

Continuing Education Credits

If you are a nurse[% IF mft %], LMFT, or LCSW[% END %] and wish to receive a CEU certificate

Like this: RN98765[% IF mft %], MFT43210 or LSW31415[% END %].
If you only want a certificate of completion enter COMP for the license #.
[% END %] [% IF ! staff_housing && ! housing_not_needed %]

Housing Choice

$dncc_why
  • 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. [% IF ! housing_not_needed %] [% IF type == 'Total' %]
  • Prices are the total charge including meals, lodging, and use of facilities. [% ELSE %]
  • Prices are Per Person Per Day and include meals, lodging, and use of facilities. [% END %] [% IF tuition %]
    [% IF tuition_rolled %] A $tuition_name charge of \$$tuition is included in the total fees. [% ELSIF basicfull %] A $tuition_name charge of \$$tuition (or \$$full_tuition for $fulldays days) will be added. [% ELSE %] A $tuition_name charge of \$$tuition will be added. [% END %] [% END %] [% END %]
  • Camp sites are walk-in style with parking nearby. [% IF covid_vax %]
  • COVID-19 Notice
    • Covid waivers are required. [% IF strangers_share != 'yes' %]
    • Shared accommodations (Dormitory, Triple, Double) may only be reserved for families/friends registering together. If you are coming alone you must choose a Single accomodation. [% END %]
    [% END %]

  • 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.
$housing_fees
1st 2nd Housing Cost

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

  1. Make sure that they register separately.
[% IF !outdoors && cabin_choice %]

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

[% END %]
[% END %]
[% IF donation %]

Tuition

$donation_msg $donation_input
[% END %]

Gift Card

[% IF discount_code %]

Discount Code

[% END %]

Preferences

[% IF ! pr && ! housing_not_needed %]

Carpooling

  2. Privacy Concerns?
[% END %]

How did you first hear about this program?

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

[% IF kayakalpa %]
[% END %]

Donation

  1. As we work to recover from Covid closures and related expenditures, we invite you to consider making a donation to Mount Madonna Center. Your gift will support stewardship of this vibrant learning community, inspirational environment, and sacred land.
    Mount Madonna Center is a 501(c)(3) charitable organization. EIN #51-0174679

Dietary Restrictions

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

Additional Requests

[% IF ! housing_not_needed || mountain_experience %] [% IF ! pr || (children_welcome && ! mountain_experience) %] Include the following in your additional requests: [% END %]
    [% IF ! pr && ! mountain_experience %]
  • Arrival and/or departure dates if they differ from your program's. [% END %] [% IF children_welcome && ! mountain_experience %]
  • 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. [% END %]
[% END %]

Important Notes

    [% IF ! children_welcome && ! housing_not_needed %]
  • 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).
    • [% END %]
  • $canpol
    • [% IF ! housing_not_needed %]
  • 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: programs@mountmadonna.org.
    • [% END %]