Grief Ritual Convergence
The Death & Grief Rites Revival Project

May 14 - 16, 2021
Ecology Retreat Centre
Mono, ON
Contact Information
Full Name *
Preferred Name/Pronoun
Email *
Phone Number *
Street Address, City, Province, Post Code *
Emergency Contact
Emergency Contact Name *
Phone Number *
Medical & Dietary Information
Allergies and other physical/medical/emotional conditions may be relevant to your participation in this program: *
Are you currently taking any medications? *
If yes, please specify:
Dietary Requirements *
Fee Overview
Total Fees are:

$520 before March 31, 2021 (paid in full)
$600 after March 31, 2021

Fee Overview:

- Fees include: All practices, private accomodation, all meals (Breakfast, Lunch and Dinner) and shared use of bathrooms & showers.
- All fees are in Canadian Funds
- Payment plan available on Total Fees of $600

Cancellation Policy:

- There are no cancellations
- Should the program be canceled by The Death & Grief Rites Revival Project (i.e. due to COVID-19) all payments will be refunded in full.
Payment Details
After your registration has been reviewed, you will receive an email confirming your attendance and preferences along with payment instructions. A receipt of payment will be sent within 24 hours of payment along with your welcome package.
Engagement Policy
Our co-created environment is a safe space for sacred practice for all persons regardless of gender, gender identity and expression, sexual orientation, disability, physical appearance, body size, race, ethnicity, age and theological or spiritual perspective.    

It is expected that all individuals participating in this program will do so in the spirit of non-judgement, personal integrity, respect for confidentiality and sensitivity to the experience of others. 

Because we are converging to create and hold space that is psychologically, emotionally and physically safe to contain our individual and collective vulnerability, it is extremely important that your participation includes your agreement to uphold the above precepts and reject the following conduct:  

- Harassment, deliberate intimidation, bullying and other behaviours causing distress to a reasonable person 
- Inappropriate or unwanted touch 
- Unwelcome sexual or other personal attention 
- Theft
- Use of intoxicants such as alcohol, cannabis* and street drugs 
- Smoking or vaping except in designated outdoor areas 
- Sustained disruption of talks or other events
- Photography without explicit verbal or written consent Advocating for or encouraging any of the above  

*If you have not already noted your use of medicinal cannabis in your application please contact us to discuss you circumstances.  CBD use is acceptable.   

Respecting the Agreement  

If you are subject to or witness an infraction of this agreement please bring it to the immediate attention of a facilitator.  Anyone asked to cease unacceptable behavior is expected to cooperate immediately.  Facilitators will take any actions reasonably necessary to ensure the safety and comfort of all participants. This may include addressing the person who is acting in breach of the agreement by way of warning or, in appropriate cases, requiring them to leave the venue without monetary refund and/or the imposition of stipulations for future attendance.   
Release of Liability
I, the undersigned participant, understand that this program is a powerful and potentially
physically and emotionally intense experience. I understand that I will not be
asked to do anything illegal, immoral, or against my will. I choose to participate in
this program of my own free will and without coercion. I recognize and understand
that this program is a wholistic healing experience, and not a form of mental,
psychological, or medical treatment and that the facilitators, while competent and qualified
to oversee this work are not medical or mental health professionals.
I take full responsibility for all my actions, conscious and unconscious, and, therefore,
release The Death & Grief Rites Revival Project (under the umbrella of Life in Death Collective Inc.) from all medical and legal responsibility with respect to my participation during the 4 day event.

Your check below, indicates that I have read and agree to the terms of this application. I have
given serious consideration to this commitment, and my intention is to participate deeply
and fully in this important work.
Registration Confirmation *
Final Notes

Upon confirmation of registration and receipt of fee, we will provide information regarding location & directions, a list of necessary and suggested items to bring and further details.

You may wish to keep a copy of this form for your personal records. If you have concerns or questions prior to the event please contact: or
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