The Whole Earth as the True Human Body: Exploring the Buddha Dharma in the Wilds of California

We offer this program strictly for people ages 18–35 to create a space tailored to the questions, transitions, and community needs common in this stage of life.

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1 Welcome

Please provide your name and email address before clicking "Continue."

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2 Registration Deposit

To register for the program, we ask for a $50 deposit when applying. Later in this application, there will be a separate box for your retreat donation. Please indicate in the next section whether you would like to include your deposit as a part of your retreat donation, or if you would like your deposit refunded to you after the retreat ends. If you are no longer able to attend and need to cancel, your deposit is eligible for a refund up to three weeks prior to the retreat start date. If the $50 deposit makes this retreat inaccessible to you, please email offerings@dharma-gates.org. If you'd like to learn more about our average retreat costs, visit this page: www.dharma-gates.org/retreatcost

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$50.00 – Program deposit$50.00 – Program deposit $50.00 – Program deposit

Guests

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3 Contact Information

Guest 1		First Name* Last Name* Email*
Guest 1		First Name* Last Name* Email*

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4 Contact Information

What would you like to do with your deposit? *	Donate my deposit to Dharma Gates. Refund my deposit after the program ends.
Address *
Address 2
City *
State/Prov. *
Zip/Postal *
Country *
Cell *
Birth Date *

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5 About You

How did you find out about this event? *
Please share your friend's first and last name.
Please specify.
Gender *	Your response helps us provide room assignments for participants.
Please describe your gender. *
What pronouns do you use?
Please let us know the pronouns you go by.
Are you currently in college or university? *
Which college or university are you currently attending? *
What is your race or ethnicity?	Asian Black or African American Hispanic or Latino Indigenous Person or Alaska Native Native Hawaiian or Other Pacific Islander White Prefer to self describe Prefer not to say Check all that apply.
Please specify your race.
Are you from a low-income background?

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6 Practice Background

Tell us about your practice background. There are no right or wrong answers—just answer in a way that feels true for you.

What inspires you to register for this event? *
Please share a brief summary of your experiences with meditation and spiritual practice. *	If applicable, include the teachers, methods, and meditation techniques you work with.
Have you attended a meditation retreat before? *	It's okay if this is your first retreat!
Please list the date, length, teachers, and the hosting organization of the four most recent. *
Are you currently involved with a sangha or meditation community? *
Please share the full organizational name of your sangha or meditation community. *
Do you have any other concerns or challenges in your life or meditation practice that would be helpful for us to know?

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7 Well-being & Support

We strive to maintain an accessible and safe environment for all participants. To that end, some questions ask about your health information. Responses are confidential, stored in a secure registration system (operated by an external provider), and only viewed by Dharma Gates staff and teachers/facilitators who need the information. Please email offerings@dharma-gates.org if you are more comfortable discussing your health with staff directly.

First and Last Name of Emergency Contact *
Relationship to Emergency Contact *	e.g., sibling, parent, friend, etc.
Phone Number of Emergency Contact *
Have you been formally diagnosed with any physical health condition(s)? *	Please answer 'Yes' if you have any condition(s) that might require support or accommodations.
Please tell us more about any relevant physical health conditions.
Do you require support with accessibility, mobility, or other specific needs? *	Answer 'Yes' if you need to request accommodations.
Please tell us more about your accessibility, mobility, or other personal needs.
Are there any significant emotional or mental health concerns you’re navigating right now that it would be helpful for us to know about? *	Write N/A if not applicable.
Are there any emotional or mental health conditions you want to let us know about? *
Please tell us more about your emotional or mental health.	Share what is comfortable and relevant to a practice environment.
Are you currently taking prescribed medication(s) for your mental or emotional health? *
If you're comfortable, please let us know your mental health medication(s).	.
Have you ever been hospitalized for mental health reasons? *
Please share the the date(s) you were hospitalized and the reason(s) for admission. *

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8 Food & Housing

Dharma Gates retreats provide nutritious vegan meals with whole grains and fresh fruit and vegetables. Accommodations are comfortable and simple. We make exceptions for sharing facilities if there is a specific medical or mental health need.

Please let us know if you have an allergy or special dietary needs. *
Please note any accommodations related to diet.	List specific allergens here.
Do you have any environmental, insect, or contact allergies? *
Please describe your environmental, insect, or contact allergies. *
Housing and bathrooms will be shared, with exceptions for those who have medical or mental health needs. Please share your housing preferences in alignment with your gender identity. *	Mixed gender housing may have men, women, and gender expansive people.
Do you have any specific sleeping needs or conditions? This information will help us make necessary accommodations. *
Please share more information here about your sleeping needs or conditions. *
Do you snore? This information will be helpful when assigning rooms. *
If necessary, would you be comfortable camping for the duration of the retreat? *
Can you provide your own camping gear? *
Do you have any extra camping gear that you could bring for others? If so, please specify.

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9 Preparing for Retreat

These questions help us estimate number of meditation supplies, our environmental impact, and identify volunteers to help our lead cook.

Please let us know if you are able to bring any of the below items—borrowing from a friend is encouraged! We will provide enough meditation cushions for everyone. *	Not applicable Blanket Meditation bench Meditation cushion Meditation mat Yoga mat Select all that apply.
Please let us know from where you'll be traveling to the retreat. This helps us approximate the environmental impact of our retreats. We are committed to reducing our retreats' carbon omissions. *	Please provide city and state
How will you travel to the retreat? *	If multiple, please share the most carbon intensive mode.
Are you interested in serving as a volunteer assistant cook for this retreat? *	We invite 2–3 participants to serve as assistant cooks. This is about 2–4 hours a day in the kitchen, sometimes during group activities. Otherwise, volunteers join the regular schedule. Prior retreat and group-cooking experience is helpful. Thank you for considering helping out!
Please tell us more about your experience either preparing food or cooking, especially for large groups.	Include any particular skills, your comfort level cooking large quantities, etc.

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10 Agreements

Please review the following consents and policies. These help us create a safe, respectful, and well-supported retreat environment.

Please affirm that you have read and agree to observe the Dharma Gates Code of Conduct. *	By checking here, I confirm that I have carefully read and agree to observe the Dharma Gates Code of Conduct while participating in all retreat activities, including arrival and departure..Teachers, staff, and participants are expected to observe them throughout the event.
Participants must attend the full retreat, arrive symptom-free, and stay home if sick. Testing may be required depending on community conditions. Cancellations within 21 days may forfeit the deposit. *	By checking here, I confirm that I understand and agree to follow the attendance and health policy.
Please read the the Liability & Release Waiver. *	By checking here, I confirm that I have read and agree to the Liability Waiver & Release.
Do you consent to Dharma Gates using your image and video from this retreat? *	Selecting 'Yes' means you grant Dharma Gates the right to use your image and video from the retreat in our newsletter, social media platforms, and other promotional materials.

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11 Please join the Dharma Gates Circle of Support

Dharma Gates events are offered within the practice of Dana, (दान), the Sanskrit/Pali word meaning generosity or giving. Rather than operating on a fee structure, we instead ask you to engage with us in a relationship of reciprocity, giving what feels aligned with your circumstances and values.

If these experiences are precious to you, we invite you to donate in a way that reflects that. Doing so will breathe life into our efforts, helping us to continue creating beautiful, accessible practice opportunities for young people for years to come. Please enter the amount you wish to donate in the box below.

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12 Security Check

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13 Registration Deposit

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Donations	$0

Taxes	$0

Deposit	$0

Due Now	$0 $0

Remaining Balance	$0

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	By submitting payment, you authorise Dharma Gates to send instructions to the financial institution that issued your card to take payments from your card account in accordance with the terms of Dharma Gates's agreement with you.