City Refuge Retreat

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1 Welcome

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$120.00 – Full-time participation/sustaining level

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$80.00 – Part-time participation/supporter level

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$50.00 – One-day participation/scholarship level: Please contact kosho@zendust.org to discuss part-time participation

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Dharma Name
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Address 2
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Dietary Needs	Vegan Gluten Free Dairy Free All our meals are vegetarian. We have vegan and gluten free options available as needed. Please use question #2 if you have additional allergies.
Emergency Contact Info
Meditation Experience	Do you have a meditation practice? How long have you been meditating?

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