Professional Documents
Culture Documents
General Retreat Reg - Form-Mar.10.2012
General Retreat Reg - Form-Mar.10.2012
General Retreat Reg - Form-Mar.10.2012
How to Register You may register for the retreat by email or mail. Please email the registration form to office@magnoliagrovemonastery.org or mail it to our mailing address. How to fill out the registration form: If you would like to share a room with a specific person, please register on the same form. If you do not specify a roommate, we will assign roommates by gender. For each person in your group or family, print the full name on the form. Please use an extra sheet as needed. We will be sending the confirmation information to the person and address filled out at the top of the registration form. Register by email to: office@magnoliagrovemonastery.org Register by mail to: Magnolia Grove MPC, 123 Towles Rd., Batesville, MS. 38606 Payment by check or money order, payable to Unified Buddhist Church (UBC). Confirmation: You will receive a confirmation packet in about one week after we have received and processed your registration. Included in the packet will be information about retreat activities and how to enjoy them, as well as other pertinent information. Housing Information: Due to the limited housing at Magnolia Grove MPC, you can only choose dormitory (limited couple/double room) or camping in the premises of the Monastery. All rooms are 5-10 beds (bunk beds) with public bathrooms. Transportation: Airport: Memphis International Airport (MEM), 56 miles from Magnolia Grove MPC. Shuttle service from Memphis International Airport to Magnolia Grove MPC: Please contact Jefferson Travel at (901) 3614246 to make your own reservation. Please call at least three days in advance.
FILE NO.
Address: 123 Towles Rd. Batesville, MS. 38606 Tel.: (662) 563-0956 Website: http://www.magnoliagrovemonastery.org Email: office@magnoliagrovemonastery.org
Housing Codes
DORM-A DORM-S DORM-T DORM-C CAMP PLEASE BRING YOUR OWN TENT
COUPLE
Age
Gender
Housing Codes
Amount
Contribution to help build big Meditation Hall (optional): $ Total Due: $ Amount Enclosed: $
Please pay in full upon registration. Method of Payment: ___ Cash ___ Check ___ Money Order (please make payment payable to: Unified Buddhist Church (UBC)). Please do not send cash. We also do not accept credit card payment. Please send completed form and contribution to: Magnolia Grove MPC General Retreat - 123 Towles Rd. Batesville, MS. 38606 or Email to office@magnoliagrovemonastery.org CANCELLATION/REFUND POLICY: Notice of Cancellation On or before 21 days of your arrival Refund Amount Per Person Refund of the amount paid less $25/person processing fee Notice of Cancellation Before 14 days of your arrival Before 5 days of your arrival Refund Amount Per Person 50% refund of the full fee 25% refund of the full fee
MEDICATION: Are you or anyone in your family taking certain prescribed drugs that we should be aware of? Yes No If yes, please specify who and which medication: Name: Which medication: Doctor Contact Information: Doctor Name: Telephone No.:
LIABILITY WAIVER: The following signatures indicate that participants relieve Magnolia Grove MPC from all liabilities in the event of any injury or illness incurred while visiting Magnolia Grove MPC. Meditation is a complement to, but not a substitution for psychological counseling or medication. Date / / Signed: 1. Phone: ( )
Date
Signed: 2. Phone: ( )
Date
Signed: 3. Phone: ( )
Received: ___/___/___ (Signed) _______________________ Confirmation Sent: ____/__/___ E-mail US Mail _______________
Date___/___/___ Check # __________ Bank ______________________________________ $ ________ Date___/___/___ Cash (Signature) _____________________ Date _____________ $ _______________
Balance Due: $_____________