2018 Northern California Buddhist Family Camp

2019 Northern California Buddhist Family Camp
Connecting to our Roots 飲水思源

Kindness, Compassion, Empathetic Joy, & Serenity 慈悲喜捨
Dates/Times: Sat & Sun, June 15-16, 9:00am-5:00pm*
* Sat, 7:30-9:00pm (evening program available, optional)

Location: 2304 McKinley Ave, Berkeley, CA 94703

Participant Requirements: Children must be at least six years of age and accompanied by their respective parent(s) or legal guardian(s).
Parent of Child Information
Parent of Child: Name *

First Name Last Name
Parent of Child: Gender *

Female Male
Parent of Child: Age *
T-shirt Size *

Youth-Small (Ages 6-7) Youth-Medium (Ages 8-9) Youth-Large (Ages 10-12) Small (5'4" / ~120 lbs) Medium (5'9" / ~165 lbs) Large (6' / ~185 lbs) X-Large (6'2" / ~205 lbs)
Parent of Child: Languages Spoken (please note that most of the program will be in English) *

English Chinese
Parent of Child: E-mail *
Parent of Child: Phone Number *

Parent of Child: Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Additional Family Members

Please add any family members that will be attending the camp with you. Only one application is necessary per family.
How many additional family members will be joining you? (if more than 4, please fill out another form.)

None 1 2 3 4
Additional Family Member #1: Name *

First Name Last Name
Additional Family Member #1: Gender *

Female Male
Additional Family Member #1: Age *
Additional Family Member #1: T-shirt Size *

Youth-Small (Ages 6-7) Youth-Medium (Ages 8-9) Youth-Large (Ages 10-12) Small (5'4" / ~120 lbs) Medium (5'9" / ~165 lbs) Large (6' / ~185 lbs) X-Large (6'2" / ~205 lbs)
Additional Family Member #1: Languages Spoken *

English Chinese
Additional Family Member #1: Relationship *
Additional Family Member #2: Name *

First Name Last Name
Additional Family Member #2: Gender *

Female Male
Additional Family Member #2: Age *
Additional Family Member #2: T-shirt Size *

Youth-Small (Ages 6-7) Youth-Medium (Ages 8-9) Youth-Large (Ages 10-12) Small (5'4" / ~120 lbs) Medium (5'9" / ~165 lbs) Large (6' / ~185 lbs) X-Large (6'2" / ~205 lbs)
Additional Family Member #2: Languages Spoken *

English Chinese
Additional Family Member #2: Relationship *
Additional Family Member #3: Name *

First Name Last Name
Additional Family Member #3: Gender *

Female Male
Additional Family Member #3: Age *
Additional Family Member #3: T-shirt Size *

Youth-Small (Ages 6-7) Youth-Medium (Ages 8-9) Youth-Large (Ages 10-12) Small (5'4" / ~120 lbs) Medium (5'9" / ~165 lbs) Large (6' / ~185 lbs) X-Large (6'2" / ~205 lbs)
Additional Family Member #3: Languages Spoken *

English Chinese
Additional Family Member #3: Relationship *
Additional Family Member #4: Name *

First Name Last Name
Additional Family Member #4: Gender *

Female Male
Additional Family Member #4: Age *
Additional Family Member #4: T-shirt Size *

Youth-Small (Ages 6-7) Youth-Medium (Ages 8-9) Youth-Large (Ages 10-12) Small (5'4" / ~120 lbs) Medium (5'9" / ~165 lbs) Large (6' / ~185 lbs) X-Large (6'2" / ~205 lbs)
Additional Family Member #4: Languages Spoken *

English Chinese
Additional Family Member #4: Relationship *
Background & Interest
What is your family's background in Buddhism, spirituality, or religion? *
How did you and your family find out about this program? *
Please let us know why your family is interested in participating in this retreat. *
Fees
Our goal is to make the family camp accessible for all those who wish to attend. If you need financial assistance to attend the camp, please email us directly at familycamp@drbu.edu.

Fees for retreat: $50 per person (e.g. $50 x 3 people = $150)

You can pay after you are accepted and arrive at the camp.

Or you can make a check out to "DRBA" memo "BBM family camp" and mail to:

Buddhist Family Camp
Berkeley Buddhist Monastery
2304 McKinley Ave
Berkeley, CA 94703
Conclusion
Liability Waiver

All participants this camp organized by Dharma Realm Buddhist University (DRBU), Da Hsiung Vihara, and Hsuan Hua Foundation agree to consent to participate voluntarily and understand and agree that services and tools offered by these organizations and affiliates are not intended to replace or be a substitute for medical or psychiatric care, and are not intended to be interventions for any disorders.

Participants must be in good physical and mental health prior to attendance at this camp. DRBU, Da Hsiung Vihara, and Hsuan Hua Foundation, along with affiliated groups, sponsors, or individuals do not assume any liability. All participants waive and expressly agree to hold harmless and release all associates and affiliates from any liability arising from participating in any events.

The liability statement: While every effort will be made to ensure an enjoyable camp, each camp participant shall assume their own responsibility for illness, lost items, or accidents during the period of this camp. Camp organizers cannot be responsible for any claimed damages.

Upon arrival, we will ask you to sign a hard copy of the liability waiver for each participant (PDF link).
Please write name below to accept liability waiver.
Camp Guidelines

In order to create a wholesome environment for your family and other participants, please abide by the following guidelines.

Full Participation: Please participate in all scheduled activities. If you will be absent or need to leave, please speak to one of the camp organizers.

Follow the Five Precepts: (1) not killing, cherishing life; (2) not stealing, respecting others’ property; (3) not engaging in sexual misconduct, respecting relationships; (4) not lying or slandering, honesty and responsibility; (5) not using intoxicants, clarity of mind.

Vegetarianism: In the spirit of compassion and cherishing all beings, all meals will be vegetarian. Please do not bring meat, eggs, or food with onions, garlic, chives, scallions, or leeks.

Comfortable and Modest Clothing: Comfortable, loose-fitting clothing is best for meditation and also creates fewer distractions for others. Please refrain from wearing mini-skirts, shorts, tights, leggings, yoga pants, see-through clothing and sleeveless shirts. Also please do not wear perfume during the camp.

Break from Digital Devices: This camp is a rare opportunity to spend time together free of the distractions from our digital devices. We ask everyone to not use cell phones, laptops, computers, tablets and music players during organized activities.
I have read and agree to abide by the guidelines for attending the camp. *

Yes
Do you have any other comments or questions?
Should be Empty:

2019 Northern California Buddhist Family Camp

Connecting to our Roots 飲水思源

Parent of Child Information

Additional Family Members

Background & Interest

Fees

Conclusion