Yana Event

Name*

First NameLast Name

Email Address:*

example@example.com

Phone Number*

Please enter a valid phone number.

Age*

Please indicate your pronouns (optional):

How did you hear about this retreat and/or Sarana Institute?*

What inspired you to join us for the Yana Retreat?*

Do you have any current or former mindfulness and meditation practice? If so, please share with us your experiences with meditation training and/or practice. If you have a daily practice right now, what does it consist of?*

What do you hope to gain by participating in this retreat? What do you imagine the ripple effects might be in your life?*

This retreat has all meals catered. Meals will not be strictly vegetarian, but there will be many vegetarian options. Please indicate if you need any of the following:

strictly gluten free mealsstrictly dairy free mealsstrictly vegan meals

Do you have any other allergies, sensitivities, or dietary choices we need to be aware of?*

Emergency Contact Name*

Emergency Contact Phone Number*

Alternate Emergency Contact*

Alternate Emergency Contact Number*

Where will you be travelling from to get here? *We are asking this to support carpooling when possible as some participants may be arriving from other towns or cities.*

Please indicate one of the following for carpooling purposes:

I am not available to carpoolI can offer a ride to someone also travelling from my areaI would appreciate a ride from someone also travelling from my area

If you are offering a carpool ride, how many people would you be able to accomodate?

Do you need to set up a payment plan with us? (an initial payment of $100 is required to process your registration)

YesNo, I will pay in full

Do you need financial assistance to support you to attend this retreat?

YesNo

If you indicated Yes to the above, please let us know what you are able to contribute in total. Your total contribution can be split over a payment plan and we will contact you shortly to set up our next steps. The Total I Can Contribute Is:

Please confirm your choice:*

Pay in full $495 (cad)Payment plan with $100 (cad) depsitApply for a partial bursary

Due to the generous support of the Lang Family Foundation, we are able to offer this retreat at a greatly reduced rate.

Payment Options:

1. Send an Interac e-transfer to info@saranainstitute.org through your online banking system with your chosen amount (full or deposit). Password should be 'meditation'. Complete the form and click 'Submit'. We encourage you to pay by e-transfer or cheque when possible.

2. Pay via credit card or PayPal account using the PayPal options below. Complete the form and click 'PayPal Checkout'.

3. Send a cheque to Sarana Institute directly with your chosen amount (full or deposit) Complete the form and click 'Submit'.

Have you reviewed our cancellation policy? You can do that here.

Please indicate your payment method for either your full payment or your deposit:

Send an Interac E-TransferPassword should be 'meditation'. Please send your Interac E-Transfer with your full payment($500) or deposit for payment plan ($100) to info@saranainstitute.org after you register.

$ Free CAD

Mail a Cheque to Sarana InstitutePlease send a cheque to the address provided at the bottom of this form with your full payment($500) or deposit for payment plan ($100)

$ Free CAD

PayPal - Full FeeSelect this option to pay with your credit card (no account required) or with your PayPal account. Choose the Paypal Checkout to submit your registration.

$495.00CAD

PayPal - Payment PlanSelect this option to pay your payment plan deposit with your credit card (no account required) or with your PayPal account. Choose the Paypal Checkout to submit your registration

$100.00CAD

Bursary Click this option if you need additional financial assistance to attend the retreat. We have a limited fund to issue partial bursaries. We will be in touch with you shortly to discuss next steps. You will be able to set up a payment plan with a partial bursary. Your first installment will secure your registration.

$ Free CAD

Total

$0.00CAD

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Yana Retreat Registration

Program Fees and Payments:

Bursary & Financial Assistance