MC TEST – The Four Immeasurables Retreat: Cultivating Vast and Profound Connection Copy

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1 Welcome

2 Choose Your Tier

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Tuition*

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Supported Twin Room

Rooms include a bed with freshly cleaned bedding, pillows, and a wool blanket. Other furnishings include a nightstand, a table...

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Supported Twin Room
Rooms include a bed with freshly cleaned bedding, pillows, and a wool blanket. Other furnishings include a nightstand, a table lamp, and a small dresser, fit with a small altar space, should you choose to use it. Towels, a hamper, a waste basket, and an alarm clock are also included for your use during your stay. Shared bathrooms are located nearby in the dorm wing. For those with limited financial resources who will benefit from participating in this program. This reduced fee is supplemented by the community.

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Suggested Twin Room

Rooms include a bed with freshly cleaned bedding, pillows, and a wool blanket. Other furnishings include a nightstand, a table...

Guests in Room:
In rooms

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Suggested Twin Room
Rooms include a bed with freshly cleaned bedding, pillows, and a wool blanket. Other furnishings include a nightstand, a table lamp, and a small dresser, fit with a small altar space, should you choose to use it. Towels, a hamper, a waste basket, and an alarm clock are also included for your use during your stay. Shared bathrooms are located nearby in the dorm wing. For those with sufficient financial resources who can pay for the experience without difficulty.

Close
×
More Photos
Sold Out

Sponsored Twin Room

Rooms include a bed with freshly cleaned bedding, pillows, and a wool blanket. Other furnishings include a nightstand, a table...

Guests in Room:
In rooms

More Details +

$0

$0

$0
Sponsored Twin Room
Rooms include a bed with freshly cleaned bedding, pillows, and a wool blanket. Other furnishings include a nightstand, a table lamp, and a small dresser, fit with a small altar space, should you choose to use it. Towels, a hamper, a waste basket, and an alarm clock are also included for your use during your stay. Shared bathrooms are located nearby in the dorm wing. For those with the financial resources and the desire to support access for others.

Close
×
More Photos
Sold Out

Supported Online

For those with limited financial resources who will benefit from participating in this program. This reduced fee is supplemented by...

Number of Guests:
In rooms

More Details +

$0

$0

$0
Supported Online

For those with limited financial resources who will benefit from participating in this program. This reduced fee is supplemented by the community.

Close
×
More Photos
Sold Out

Suggested Online

For those with sufficient financial resources who can pay for the experience without difficulty.

Number of Guests:
In rooms

More Details +

$0

$0

$0
Suggested Online

For those with sufficient financial resources who can pay for the experience without difficulty.

Close
×
More Photos
Sold Out

Sponsored Online

For those with the financial resources and the desire to support access for others.

Number of Guests:
In rooms

More Details +

$0

$0

$0
Sponsored Online

For those with the financial resources and the desire to support access for others.

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3 People in your group

4 Optional Items

5 Practitioner Info

Cell Phone *
Preferred or Chosen Name	We’d like to address you as you prefer. If you go by a name other than your legal name, please share it here. If not, please leave blank.
Pronouns	If you'd like, you can share your pronouns with us so we may address you correctly.
Please share your pronouns:
Address *
Address 2
City *
State/Prov. *
Zip/Postal *
Country *
Emergency Contact Name *	Please include the name of someone we can reach out to in the event of an emergency who will be available during this program.
Emergency Contact Relationship *
Emergency Contact Phone *	Please include the best number to reach your emergency contact while you are participating in this program. This will not be used for anything except to care for you in the case of an unexpected crisis or emergency.

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6 Tell Us More

How did you hear about this retreat? *
Please describe:
What is your intention for attending this retreat?
What is your experience with meditation? *	Daily Meditation Practice Some Experience Beginner Other
Please describe:
New to Namchak? *	Yes, this is my first Namchak offering. No, I have attended Namchak offerings previously.
If so, which one(s)?	One Community Gathering Stepping into Meditation and Community Introduction to Calm Abiding Walking the Path Ancient Wisdom Engaged Compassion in Action Four Immeasurables Retreat Reset and Renew Retreat Fundamentals of Tibetan Ritual Arts Retreat Green Tara Retreat Morning Meditations Saving Each Other Together Prayer Groups Other Please check all that apply.
Please describe the offering you attended:
Comments or Special Needs	Is there anything else we should know in order to be able to best support your learning experience?

7 Agreements

Community Commitments *	I will abide by the Community Commitments.Please review and acknowledge your agreement to abide by our Community Commitments
Terms and Conditions *	I accept the terms and conditions.Please read the terms and conditions
Minor Release Form for Participation in this Event if Applicable	Agreed to and Accepted by a Parent or Legal Guardian
Email newsletter	Please send me the email newsletter.

8 Travel Details

We are so looking forward to seeing you! To help us prepare for the upcoming retreat, please provide the following information so we can best plan your travel and transportation.

How will you be arriving to Missoula? *	Flying Driving / Carpooling
Namchak contracts a local shuttle service and offers a shuttle from Missoula to the Namchak Retreat Ranch in Hot Springs, MT for in-person retreats.	I acknowledge that if requests are made beyond these pick up and drop off locations (direct to/from Missoula and the Namchak Retreat Ranch) and additional fees are added, they will become the responsibility of the rider making said request.Please indicate acknowledgement of our policy for utilizing the shuttle service. (The shuttle service charges $1/minute for added stops/waiting).
What date are you flying into Missoula?
What is your scheduled flight arrival time?
What airline are you flying into Missoula?
Please share the name of the airline:
What is your arrival flight number?
What date are you flying out of Missoula?
What is your scheduled flight departure time?
What airline are you flying out of Missoula?
Please share the name of the airline:
What is your departure flight number?
Please provide your round trip driving plans.	Where are you driving from? Are you carpooling with any other retreat attendees? Our rolling arrival is between 3:30-5PM on the day retreat begins. If you need accommodations outside that window, please contact Meggan (mquigley@namchak.org). We will provide parking information as the retreat nears.
If you are driving, would you be willing to offer another participant a ride that is conducive with your schedule?
Please include any additional information we should know regarding your flight and overall travel to Missoula. *

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9 Health Details

Events and retreats at the Namchak Retreat Ranch, located in a remote and serene setting, often incorporate meditation practices and practical activities that can be challenging on emotional, mental, and physical levels. Given our remote location, to ensure that we can offer effective support in case of an emergency, we request that you fill out this form with as much detail as possible. All provided information remains confidential and will only be used in the context of an event or retreat. Should you choose not to respond to any question, please indicate with 'N/A.'

Birth Date *
Insurance Provider with Policy or Group # *
Do you have any physical health conditions or concerns? *	Feel free to be specific even if something isn't a "concern", per se. (For example, we would want to know if you have reactions to bee stings or certain foods - even if it's not an allergy or health concern. Should anything arise, we want to care for you in the best way possible.)
Do you have any mental health conditions or concerns? *
Do you regularly take any medications? Please list if so. *	Please explain any special circumstances concerning medications you will be bringing with you, if any. (For example, please specify if a medication you take requires refrigeration.)
Is there anything else you would like to share regarding your mental or physical health? *

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10 Accommodations & Food Details

Do you experience any serious mobility or sensory limitations we should be aware of? If not applicable, please write N/A. *	This includes the use of aids like wheelchairs, crutches, or service dogs, as well as conditions such deafness or blindness. Knowing about these conditions in advance of retreat allows us to connect with you to see how we can best create a supportive learning environment for you.
Which term best describes your diet? *	Vegan (no meat, no eggs, no dairy) Vegetarian (no meat) Flexitarian or Omnivore (flexible on meat, dairy, eggs; no restrictions)
Do you have any food allergies or intolerances? *	Yes, I have food allergies and/or intolerances. No, I do not have food allergies or intolerances.
If so, please describe: *	Please be sure to highlight any allergies which could be life threatening such as shellfish or peanut that have caused an anaphylaxis reaction in the past. Please also specify significant intolerances, such as Gluten-Free.
If you have experienced an anaphylactic reaction to food specified above, do you travel with an EPI pen as a medical remedy? *	Yes, I travel with an EPI pen. No, I do no travel with an EPI pen. N/A (I have never experienced an anaphylaxis.)
On a scale of 1-10, how spicy do you enjoy your food? *	1 2 3 4 5 6 7 8 9 10 1: No spice for me, thanks! 10: Bring the heat!
Is there anything that affects your digestion in a negative manner? What aids your digestion? *
Is there anything else you would like to share regarding your diet? *

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

1 Welcome

2 Choose Your Tier

Tuition*

Supported Twin Room

Suggested Twin Room

Sponsored Twin Room

Supported Online

Suggested Online

Sponsored Online

3 People in your group

4 Optional Items

5 Practitioner Info

6 Tell Us More

7 Agreements

8 Travel Details

9 Health Details

10 Accommodations & Food Details

11 Donate

12 Security Check

13 Payment