Dhamma Dena Retreat Registration
"Surfing the Waves of Impermanence" with Sandy Boucher & Martha Boesing
Thursday, September 28th - Monday, October 2nd, 2017
Email address *
First Name *
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Last Name *
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Street Address *
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City, State, Zip *
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Phone numbers (list all, indicating cellphone) *
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Date of birth *
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Gender identification *
Arrival Date *
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Check here if you would like to arrive early to help set up the retreat:
Departure Date *
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Ride Needed from Palm Springs Airport? (Arrival)
Please select your flight arrival time, with AM or PM
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What is your Arrival Airline & Flight Number?
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Ride Needed to Palm Springs Airport? (Departure)
Please select your flight arrival time, with AM or PM
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Time
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What is your Departure Airline & Flight Number?
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Special Dietary Needs
Please note that we will be offering gluten-free options for all meals.
Do you have any special needs for housing, or for your health?
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Have you attended a retreat here before? *
Are you new to Vipassana meditation? *
Where did you hear about the retreat? *
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Scholarship/Work Exchange Requested
$100 deposit *
NOTE: Your registration is not confirmed without a deposit
A copy of your responses will be emailed to the address you provided.
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