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Registration Form
Please read our notice below and complete this form to begin the application process for our Sri Lanka Pilgrimage.
Email address *
Sri Lanka Pilgrimage with Dr. Miles Neale - Nov.30-Dec.13, 2019
Thank you for your interest. The following application must be completed for you to be considered for our pilgrimage. We want to ensure a cohesive group dynamic and quality experience for all those involved.

Our pilgrimages generate a lot of interest and space is limited. We factor in many variables in our decision such as your past meditative experience, mental and physical fitness, and suitability within the overall group dynamic. Priority is given to those enrolled in our Contemplative Studies Program (www.GradualPath.com), as well as participants and those waitlisted from prior pilgrimages. If you have never studied with Miles before, we suggest you join the CSP to develop familiarity with his teachings.

We do NOT discriminate based on such things as age, gender, race, religion, sexual orientation or socio-economic status.

Please check the following that apply to you. *
Required
Name *
First and last name
Date of Birth *
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Email *
Phone number *
Home Address (street address, city, state, ZIP, country) *
Emergency Contact (name, relationship to you, phone number and email *
Passport country of issue *
Passport number *
Passport date of expiration (must be valid for six months after we depart on Nov.30, 2019) *
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DD
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Room Preference *
If sharing a room, what is your travel companion's name or who would be your preferred roommate? *
If sharing a room, do you prefer *
List any medical and/or psychological conditions that you have as well as any prescribed medications (including dosages) you are taking. *
Will you be bringing any medicine requiring refrigeration or special medical devices? *
Have you ever traveled to Sri Lanka or a similar developing country in Asia before? If so, where and when? *
Have you ever been on a Buddhist pilgrimage before? *
Miles’ teachings will meet criteria for 20 hours of Yoga Alliance continuing education in Buddhist philosophy, ethics and meditation practice offered by an expert in an allied field. Are you a yoga, meditation teacher or healer that requires CE units? *
Required
Karmic activity is central to Buddhist pilgrimage. Would you like to make a contribution to our scholarship fund to support a pilgrim of lesser means? *
Required
Thank you for taking the time to apply. We will let you know about our decision via email once the enrollment phase concludes late May. If accepted you must secure your spot with a $500 nonrefundable deposit and complete the required forms (Liability Waiver, Medical Clearance and Travel Insurance) which will be emailed to you.
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