RETREAT REGISTRATION FORM 1Choose Retreat2Registrant Info3Our Policies4 ***NEW!*** You can now create a user account which will save you time when filling out the registration form! CLICK HERE to set up your account. You will be returned to this page and logged in automatically once the account creation form has been submitted. If you have an account and are not already logged in, you can LOG IN here. This field is hidden when viewing the formSubmission Date:REGISTERING FOR A RETREATThis field is hidden when viewing the formSelect retreat type:* Teacher-Guided Group Retreat Please proceed to the next section for the pull-down list of group retreats currently open for registration.This field is hidden when viewing the formTEACHER-GUIDED GROUP RETREAT REGISTRATIONPlease select the retreat you would like to attend from the menu below.This field is hidden when viewing the formChoose a retreat:*Retreats marked with an asterisk require experience. Please be sure to reflect this in the “Meditation Experience” section.Choose a retreatFebruary 14 – 21, with Carole Melkonian, 7 nights*February 21 – March 2, with Jason Bartlett, 9 nights*March 7 – 13, with Tina Rasmussen, 6 nightsMarch 14 – 20, with Ayya Santacitta Bhikkhuni and Kate Davies, 6 nightsMarch 21 – 30, with Alexis Santos, 9 nights*April 4 – 10, with Santikaro, 6 nightsApril 11 – 17, with Tina Rasmussen, 6 nights*April 18 – 24, with Ayya Ānandabodhī Bhikkhuni, 6 nightsApril 25 – May 1, with Jason Bartlett, 6 nightsMay 16 – 21, with Mark Nunberg & Shelly Graf, 5 nightsMay 23 – 28, with Keri Pederson & Tim Geil, 5 nightsMay 30 – June 5, with Murray Kennedy & Patsy Boyer, 6 nightsJune 6 – 19, with Ayya Santussika Bhikkhuni & Ayya Cittānandā Bhikkhunī, 13 nights*June 20 – 26, with Santikaro, 6 nightsJune 27 – July 6, with Kamala Masters, Steve Armstrong & Deborah Helzer, 9 nights*July 18 – 31, with Willa Thaniya Reid & Elizabeth Day, 13 nights*August 8 – 21, with Tina Rasmussen, 13 nights*October 3 – 16, with Santikaro, 13 nights*This field is hidden when viewing the formRetreat Name(hidden) Copies the LABEL (name of retreat) from Retreat List ( Field 1) for DB Entry, uses JS Code from ( contained in Field 61) to copy Label instead of Value RETREAT CHOICEThis field is hidden when viewing the formPlease see the Retreat Information page for details. External Registration This field is hidden when viewing the formDeposit Required Yes No Please click HERE to register for this event* This retreat is monastic led.* This retreat is suitable for beginners.* This retreat requires that you have completed at least three 6-day silent, residential, Buddhist meditation retreats, with at least one held in either a Theravada or Mahayana tradition.* This retreat requires that you have completed at least three 6-day silent, residential, Buddhist meditation retreats, at least one of which was in the Theravadin/insight tradition.* This retreat requires that you have completed at least 2 silent, residential, Buddhist meditation retreats of a minimum of 6 days* This retreat requires that you have completed at least one silent, residential Buddhist meditation retreat of at least 6 days with Alexis Santos.* This retreat requires that you have completed at least one 6-day silent, residential, Buddhist meditation retreat.* This retreat requires that you have completed at least one silent, residential Buddhist meditation retreat of at least 6 days.* This retreat requires that you have completed at least three silent, residential, Theravadin Buddhist meditation retreats of a minimum of 6 days, at least one of which has been with one or both of these teachers. THIS RETREAT WILL BE DRAWN AS A LOTTERY RETREAT. Registrations that are submitted within the first 48 hours after registration opens and meet the eligibility requirements will be included in the lottery pull.* This retreat requires that you have completed at least one silent, residential Buddhist meditation retreat of at least 3 days.* This retreat requires that you have completed at least one silent, residential Buddhist meditation retreat of at least 5 days.* Registration for this retreat requires filling out the pre-registration questionnaire before proceeding. (link will open in a new tab)Questionnaire Validation Number** This retreat requires that you have three or more years of vipassana meditation used as your primary spiritual method; plus a total of three or more retreats of 6 days or longer in the insight/vipassana tradition; plus a willingness to challenge oneself.* This retreat requires that you have completed at least one silent, residential Buddhist meditation retreat of at least 5 days.* This retreat requires that you have completed at least one silent, residential Buddhist insight/vipassana retreat of any length.* Experience with breath-based mediation and having completed at least one 6-day silent, residential, Buddhist meditation retreat or multiple shorter retreats.* This retreat is for ages 18-35.* This retreat is for self-identified women.* This retreat requires an initial $500.00 deposit. This deposit will be put towards the tiered rate you have chosen. Any remaining balance will be charged on the due date posted in the retreat description. * This retreat requires an initial $1000.00 deposit. This deposit will be put towards the tiered rate you have chosen. Any remaining balance will be charged on the due date posted in the retreat description. * This retreat has special requirements. Please check the retreat listing for more info.* Registration for this retreat is closed at this time. * This retreat is now waitlisted. CONTACT INFORMATIONName* First Middle Last Email*Please note that this is the email to which we’ll send all retreat-related correspondence. Address*Please enter letters and numbers only in the address fields. For US and Canadian addresses please enter no more than 2 letters in the State field. Registration may fail if any special characters are entered (#, -, comma, etc). Street Address Address Line 2 City State / Province / Region ZIP / Postal Code CountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Cell Phone*Please enter numbers only, no dashes or special characters. Alternate PhonePlease enter numbers only, no dashes or special characters. Text Message Consent* Yes, I agree to receive text messages from Cloud Mountain for the purposes of urgent retreat related information including but not limited to waitlist communication, payment finalization, and road or weather concerns. No, I do not want to receive text messages from Cloud Mountain. PRIVACY POLICY: You are welcome to cancel at any time by emailing info@cloudmountain.org. Your text options are also updated each time you register. We do not, in any way, sell your information. Occupation*Age*Gender*Please indicate your gender identity. Male Female How did you hear about this retreat?*Check all that apply. Family member Friend Cloud Mountain website Cloud Mountain mailed flyer Cloud Mountain email Teacher Sangha Internet Search Attended a prior retreat with this teacher(s) Other This field is hidden when viewing the formHow heard about us (copy all checkboxes for DB)If other, please describe:*EMERGENCY CONTACT INFORMATIONMedical Doctor*Doctor Phone Number*Emergency Contact Name*The contact you provide should be someone who is able to physically connect with and check on you.Emergency Contact Phone Number*PERSONAL INFORMATIONThis information helps us make your retreat experience as smooth as possible. We do our best to accommodate special medical needs. HEALTH INFORMATION: Cloud Mountain is located in a rural area and there are no physicians or health care professionals on staff.Do you snore loudly?* Yes No On a scale of 0 – 10, with 10 signifying excellent ability and 0 signifying complete inability, please rate your ability to walk 500 feet or more uphill several times per day.*10 – excellent ability9876543210 – complete inabilityWill you forgo regular accommodations and camp instead?* Yes No What camping style?* Vehicle Camping Tent Camping Do you have an accessibility request?*Do you have an accessibility request, including but not limited to, no footboards for tall individuals, a special chair for weight, height, or medical needs, frequent nighttime bathroom use? Yes No Do you have a health condition or impairment that would affect your housing, yogi job, or facility use?We do our best to ensure your comfort while on retreat but are limited in accommodation options Yes No Please explain your situation.*This box is limited to 300 characters. Please feel free to email us at info@cloudmountain.org if you need to provide more detail than will fit.Do you have any food allergies or dietary restrictions?*We serve a lacto-ovo vegetarian menu (contains dairy and eggs.) Yes No Diet Details*If you have a severe food allergy please indicate this below. Dairy-free Wheat-free Vegan Peanut Allergy Other This field is hidden when viewing the formFood Restrictions (copy all checkboxes for DB)If other, please describe:*60 characters maximumAdditional DetailsUse this box to alert us to severe food allergies, including the severity of your reaction, or additional dietary restrictions. The box is limited to 300 characters. Please feel free to email us at info@cloudmountain.org if you need to provide more detail than will fit.In regards to your dietary restrictions, please note that we do serve a vegetarian diet. We use tofu, beans, and/or lentils as a protein source in many dishes. For lunch, we serve a grain (usually rice), a main course (such as dal, or tofu, or tempeh), a vegetable, and salad. For dinner, we serve soup and artisan breads. An ingredients list will be presented with all prepared meals. We also keep a stocked snack table, available at all times to retreatants, which contains fruit (apples, oranges, bananas), whole-grain crackers, rice cakes, bread, peanut butter, and jam. We do offer non-dairy, non-wheat, and vegan options when people request, and also make non-gluten, non-wheat bread available. For retreatants who have dietary restrictions other than non-dairy, non-wheat, or vegan, we recommend that you bring along some supplementary food of your own to fill in with the provided food that you can eat. We offer refrigerator space, use of the microwave in the dining hall, and shelf space to those retreatants who do not fit into what we offer for dietary restrictions. We can also offer you plastic containers so that you can put aside portions of dishes that we serve during the retreat that work for your dietary needs to eat at later times when what goes out on the table won’t work for you. In the event that you are registered into the retreat, please ask the cook for directions on where & how to store your food. With the below initialed acknowledgment, I agree to take sole responsibility for ensuring that my diet at Cloud Mountain is in accordance with my allergies, health requirements and dietary preferences. I understand that it will be my responsibility to personally supplement my diet with all foods and snacks beyond the scope of the vegetarian, vegan, and wheat-free options that Cloud Mountain Retreat Center can provide. With the below initial, I also release Friends of Cloud Mountain, the owners or Cloud Mountain Retreat Center, any of the organizations officers, directors, employees, members, agents, teachers, contractors, or volunteers from liability and responsibility for any severe allergic reaction by the consumption of food that is not in accordance with my personal medical allergies and dietary restrictions. If you have any questions or concerns regarding the food that Cloud Mountain Provides during retreat, please contact us at info@cloudmountain.org or call us at 360-274-4859 or toll-free (within the United States) at 1-888-465-9118.Please check:* I confirm that I have no known food allergies OR that I have read and accept Cloud Mountain’s food allergy policy. BEDDINGCloud Mountain can offer those flying in from out of the area the option of renting bedding, towels and linens for a $10 rental fee. Due to limited quantities, bedding packets should be reserved as early as possible. If you are not flying in, please plan to bring your own bedding.Do you wish to rent a bedding packet?* Yes – $10.00 No – $0.00 RIDE SHARERide sharing is a great way to simplify retreat transportation while being conscious of our impact on the environment. If you sign up for ride share, you will receive an e-mail two weeks prior to the start of your retreat containing contact information for other participants with whom you may arrange rides.Would you like to participate in ride sharing?* Yes No Do you wish to:* Give Receive Either, I’m flexible One way or round trip?* one way round trip From where to where?If giving, to how many?*123456789From where will you be travelling?*e.g. “Seattle, WA” or “Portland International Airport”Additional Ride Share Details:MEDITATION EXPERIENCEIs this your first retreat through Cloud Mountain?* Yes No Are you brand new to meditation?* Yes, I am brand new. No, I have experience. How long have you practiced?*In what traditions?*PREREQUISITES FOR EXPERIENCED STUDENT RETREATSThere are experience prerequisites in place for this retreat.*Please use this field to provide the information to verify that you meet those prerequisites, including at least approximate dates, length, teacher(s) and location of previous retreats.We are setting a high bar for retreats for advanced students. In the past, the definition of an experienced or advanced student has generally been characterized by the amount of formal retreat time in which one has engaged. While time logged on the cushion can be an important aspect of experience, we do not find this measure alone to be a meaningful gauge of the quality of a student’s practice. We see an advanced student as someone who has developed a balanced practice, with sincere and diligent attention to practicing sila (ethical/moral conduct) and dana (generosity), in addition to bhavana (cultivation of mind). Sometimes yogis engage in unwholesome behaviors indicative of a need for additional development. Behavior checklist:*Please review and check all. Arriving late or leaving a retreat early without prior permission (except in the case of an emergency) Lying or manipulating to secure a single room or other personal preferences Not fulfilling yogi job commitments Not offering dana to the teacher (of money, volunteer energy, or another expression of generosity/gratitude) Not offering dana to the staff (of money, volunteer energy, or another expression of generosity/gratitude) Making demands and expressions of entitlement Please review and check each item of the above list so that we are sure you fully understand what is considered unwholesome behavior at an experienced/ advanced student retreat. All of these behaviors create hardship and have a corrosive effect on our collective ability to keep the Dhamma alive, available and accessible. It is our belief as a Dhamma organization that those who aspire to take their wisdom practice to deeper levels should not neglect the vital foundational practices of dana and sila. All practitioners are welcome on any of our open retreats. However, in order to be considered a suitable candidate for an experienced/ advanced student retreat, these new criteria are in place to create the most fertile field of practice for all who attend and to provide adequate support for the teachers and retreat center who are gifting these practice opportunities to the world. MASKING AND TESTING POLICYPlease review our current Public Health & Safety Guidelines Public Health & Safety GuidelinesSignature*I acknowledge that I have read, understand and agree to the Masking and Testing Policy RETREAT ATTENDANCE POLICY(Please note: Non-refundable portions of retreat fees are also non-transferable to other individuals or retreats) Attendance for the full length of the retreat is required, including timely arrival, timely departure and full participation in work meditations. These are extremely important areas for maintaining the integrity of the retreat as a whole and for enabling Cloud Mountain to continue to offer retreats that are grounded in the tradition of a cooperative and interdependent structure. Late arrivals and early departure requests are only granted under exceptional circumstances. Any exception request to the policy to arrive late, depart early or participate in work meditations needs to made and approved by both the retreat center and the teacher(s) prior to registering into the retreat. Your space on the retreat may be withdrawn and a cancellation issued (with the appropriate cancellation fee withheld) if you discover after registering that you cannot attend the entire retreat. These areas of maintaining the integrity of the retreat environment are of such strong concern to us that an individual’s continued retreat privileges are contingent upon respecting and abiding by these expectations. A first instance of non-compliance in any of these areas will result in our sending a warning letter. A second instance will result in a one-year suspension of retreat privileges. “No shows” – those who do not alert us that they will not be attending the retreat – will not be registered for future retreats. We see these as ethical breaches; each retreatant has given their word in advance that they will abide by these expectations. Breaking these promises can be viewed as both false speech and taking what is not offered. In instances where the non-compliance is egregious, we retain the right to withdraw retreat privileges permanently. CANCELLATION POLICYSpaces on retreats are not transferable to other individuals. Non-refundable portions of retreat fees are also non-transferable to other individuals or retreats. Regretfully, we do not offer free transfers between retreats. Please see the cancellation fee schedule below. To request an exception to the cancellation policy, please provide a detailed explanation in an e-mail and send to info@cloudmountain.org. Exceptions will be considered for personal & family medical emergencies only. CANCELLATION FEE SCHEDULE: Cancellation policy for all retreats less than 5 days in length: The retreat fee, less a $50 cancellation fee, will be fully refunded if Friends of Cloud Mountain is notified more than 6 months prior to the start of the retreat. The retreat fee, less a $100 cancellation fee, will be fully refunded if Friends of Cloud Mountain is notified 6 or more weeks prior to the start of the retreat. Half of the retreat fee will be forfeited if FOCM is notified between 2 to 6 weeks prior to the retreat. Cancellation policy for all retreats 5 – 12 days in length: The retreat fee, less a $75 cancellation fee, will be fully refunded if Friends of Cloud Mountain is notified more than 6 months prior to the start of the retreat. The retreat fee, less a $150 cancellation fee, will be fully refunded if Friends of Cloud Mountain is notified 6 or more weeks prior to the retreat. Half of the retreat fee will be forfeited if FOCM is notified between 2 to 6 weeks prior to the retreat. The full amount of the retreat fee will be forfeited if FOCM is notified less than 2 weeks prior to the retreat. Cancellation policy for retreats 12 days or longer but less than 27 days: With notification to FOCM more than 6 months prior, you will receive a full refund, less the cancellation fee of $100. With notification 4 – 6 months prior, the fee for cancellation is $450. With notification 1 – 4 months prior, the fee for cancellation is $750. With notification less than 1 month prior to the start date of the retreat, the full amount of the retreat fee is forfeited. Cancellation policy for retreats that are 27 days or longer: With notification to FOCM more than 6 months prior, you will receive a full refund, less the cancellation fee of $150. With notification 4 – 6 months prior, the fee for cancellation is $600. With notification 1 – 4 months prior, the fee for cancellation is $900. With notification less than 1 month prior, the full amount of the retreat fee is forfeited. Spaces on retreats are not transferable to other individuals. Non-refundable portions of retreat fees are also non-transferable to other individuals or retreats. Regretfully, we do not offer free transfers between retreats. Please see the cancellation fee schedule below. To request an exception to the cancellation policy, please provide a detailed explanation in an e-mail and send to info@cloudmountain.org. Exceptions will be considered for personal & family medical emergencies only. CANCELLATION FEE SCHEDULE: Cancellation policy for Luminous Mind Retreat with Tina Rasmussen, August 8 – 21, 2025: With notification to FOCM more than 6 months prior, you will receive a full refund, less the cancellation fee of $300. With notification 4 – 6 months prior, the fee for cancellation is $600. With notification 1 – 4 months prior, the fee for cancellation is $1000. With notification less than 1 month prior to the start date of the retreat, the full amount of the retreat fee is forfeited. Please check:* I acknowledge that I have read, understand and agree to the Retreat Attendance Policy / Cancellation Policy. PRICINGThis field is hidden when viewing the form2025 3 Day Retreat – Please select the rate that you can contribute for this retreat.*Please note that the Cloud Mountain Cancellation & Housing Policies remain the same & are not based on the price you choose. Click here for more information about tiered fees. Generosity Tier – $415 plus dana offerings Base Tier – $315 plus dana offerings Subsidized Tier – $265 plus dana offerings 2025 5 Day Retreat – Please select the rate that you can contribute for this retreat.*Please note that the Cloud Mountain Cancellation & Housing Policies remain the same & are not based on the price you choose. Click here for more information about tiered fees. Generosity Tier – $690 plus dana offerings Base Tier – $525 plus dana offerings Subsidized Tier – $440 plus dana offerings 2025 6 Day Retreat – Please select the rate that you can contribute for this retreat.*Please note that the Cloud Mountain Cancellation & Housing Policies remain the same & are not based on the price you choose. Click here for more information about tiered fees. Generosity Tier – $830 plus dana offerings Base Tier – $630 plus dana offerings Subsidized Tier – $530 plus dana offerings 2025 7 Day Retreat – Please select the rate that you can contribute for this retreat.*Please note that the Cloud Mountain Cancellation & Housing Policies remain the same & are not based on the price you choose. Click here for more information about tiered fees. Generosity Tier – $970 plus dana offerings Base Tier – $735 plus dana offerings Subsidized Tier – $620 plus dana offerings 2025 9 Day Retreat – Please select the rate that you can contribute for this retreat.*Please note that the Cloud Mountain Cancellation & Housing Policies remain the same & are not based on the price you choose. Click here for more information about tiered fees. Generosity Tier – $1245 plus dana offerings Base Tier – $945 plus dana offerings Subsidized Tier – $795 plus dana offerings 2025 Luminous Mind Retreat – Please select the rate that you can contribute for this retreat.*Please note that the Cloud Mountain Cancellation & Housing Policies remain the same & are not based on the price you choose. Click here for more information about tiered fees. Generosity Tier – $2130 plus dana offerings Base Tier – $1620 plus dana offerings Subsidized Tier – $1375 plus dana offerings 2025 13 Day Retreat – Please select the rate that you can contribute for this retreat.*Please note that the Cloud Mountain Cancellation & Housing Policies remain the same & are not based on the price you choose. Click here for more information about tiered fees. Generosity Tier – $1795 plus dana offerings Base Tier – $1365 plus dana offerings Subsidized Tier – $1145 plus dana offerings 2025 6-day Enlightenment IntensiveThis is a fixed price retreat with a $660 entrance fee. 2025 6-day Enlightenment Intensive – $660 This field is hidden when viewing the formThis is a young adult retreat with an attendance fee of $250.00This is a young adult retreat with an attendance fee of $250.00 Young Adult Retreat $250.00 This field is hidden when viewing the form3 Day Retreat – Please select the rate that you can contribute for this retreat.*Please note that the Cloud Mountain Cancellation & Housing Policies remain the same & are not based on the price you choose. Click here for more information about tiered fees. Generosity Tier – $375 plus dana offerings Base Tier – $285 plus dana offerings Subsidized Tier – $240 plus dana offerings This field is hidden when viewing the form5 Day Retreat – Please select the rate that you can contribute for this retreat.*Please note that the Cloud Mountain Cancellation & Housing Policies remain the same & are not based on the price you choose. Click here for more information about tiered fees. Generosity Tier – $575 plus dana offerings Base Tier – $475 plus dana offerings Subsidized Tier – $400 plus dana offerings This field is hidden when viewing the form2024 5 Day Retreat – Please select the rate that you can contribute for this retreat.*Please note that the Cloud Mountain Cancellation & Housing Policies remain the same & are not based on the price you choose. Click here for more information about tiered fees. Generosity Tier – $625 plus dana offerings Base Tier – $475 plus dana offerings Subsidized Tier – $400 plus dana offerings This field is hidden when viewing the form6 Day Retreat – Please select the rate that you can contribute for this retreat.*Please note that the Cloud Mountain Cancellation & Housing Policies remain the same & are not based on the price you choose. Click here for more information about tiered fees. Generosity Tier – $690 plus dana offerings Base Tier – $570 plus dana offerings Subsidized Tier – $480 plus dana offerings This field is hidden when viewing the form2024 6 Day Retreat – Please select the rate that you can contribute for this retreat.*Please note that the Cloud Mountain Cancellation & Housing Policies remain the same & are not based on the price you choose. Click here for more information about tiered fees. Generosity Tier – $750 plus dana offerings Base Tier – $570 plus dana offerings Subsidized Tier – $480 plus dana offerings This field is hidden when viewing the form7 Day Retreat – Please select the rate that you can contribute for this retreat.*Please note that the Cloud Mountain Cancellation & Housing Policies remain the same & are not based on the price you choose. Click here for more information about tiered fees. Generosity Tier – $875 plus dana offerings Base Tier – $665 plus dana offerings Subsidized Tier – $560 plus dana offerings This field is hidden when viewing the form2023 2 Day Retreat – Please select the rate that you can contribute for this retreat.*Please note that the Cloud Mountain Cancellation & Housing Policies remain the same & are not based on the price you choose. Click here for more information about tiered fees. Generosity Tier – $270 plus dana offerings. Base Tier – $240 plus dana offerings. Subsidized Tier – $210 plus dana offerings. This field is hidden when viewing the form9 Day Retreat – Please select the rate that you can contribute for this retreat.*Please note that the Cloud Mountain Cancellation & Housing Policies remain the same & are not based on the price you choose. Click here for more information about tiered fees. Generosity Tier – $1035 plus dana offerings Base Tier – $855 plus dana offerings Subsidized Tier – $720 plus dana offerings This field is hidden when viewing the form2024 9 Day Retreat – Please select the rate that you can contribute for this retreat.*Please note that the Cloud Mountain Cancellation & Housing Policies remain the same & are not based on the price you choose. Click here for more information about tiered fees. Generosity Tier – $1125 plus dana offerings Base Tier – $855 plus dana offerings Subsidized Tier – $720 plus dana offerings This field is hidden when viewing the form2024 13 Day Retreat – Please select the rate that you can contribute for this retreat.*Please note that the Cloud Mountain Cancellation & Housing Policies remain the same & are not based on the price you choose. Click here for more information about tiered fees. Generosity Tier – $1625 plus dana offerings Base Tier – $1235 plus dana offerings Subsidized Tier – $1040 plus dana offerings This field is hidden when viewing the form2023 3 Day Retreat – Please select the rate that you can contribute for this retreat.*Please note that the Cloud Mountain Cancellation & Housing Policies remain the same & are not based on the price you choose. Click here for more information about tiered fees. Generosity Tier – $300 plus dana offerings. Base Tier – $255 plus dana offerings. Subsidized Tier – $210 plus dana offerings. This field is hidden when viewing the form2023 4 Day Retreat – Please select the rate that you can contribute for this retreat.*Please note that the Cloud Mountain Cancellation & Housing Policies remain the same & are not based on the price you choose. Click here for more information about tiered fees. Generosity Tier – $400 plus dana offerings. Base Tier – $340 plus dana offerings. Subsidized Tier – $280 plus dana offerings. This field is hidden when viewing the form2023 5 Day Retreat – Please select the rate that you can contribute for this retreat.*Please note that the Cloud Mountain Cancellation & Housing Policies remain the same & are not based on the price you choose. Click here for more information about tiered fees. Generosity Tier – $500 plus dana offerings. Base Tier – $425 plus dana offerings. Subsidized Tier – $350 plus dana offerings. This field is hidden when viewing the form2023 6 Day Retreat – Please select the rate that you can contribute for this retreat.*Please note that the Cloud Mountain Cancellation & Housing Policies remain the same & are not based on the price you choose. Click here for more information about tiered fees. Generosity Tier – $600 plus dana offerings. Base Tier – $510 plus dana offerings. Subsidized Tier – $420 plus dana offerings. This field is hidden when viewing the form2023 7 Day Retreat – Please select the rate that you can contribute for this retreat.*Please note that the Cloud Mountain Cancellation & Housing Policies remain the same & are not based on the price you choose. Click here for more information about tiered fees. Generosity Tier – $700 plus dana offerings. Base Tier – $595 plus dana offerings. Subsidized Tier – $490 plus dana offerings. This field is hidden when viewing the form2023 12 Day Retreat – Please select the rate that you can contribute for this retreat.*Please note that the Cloud Mountain Cancellation & Housing Policies remain the same & are not based on the price you choose. Click here for more information about tiered fees. Generosity Tier – $1080 plus dana offerings. Base Tier – $960 plus dana offerings. Subsidized Tier – $840 plus dana offerings. This field is hidden when viewing the form2023 13 Day Retreat – Please select the rate that you can contribute for this retreat.*Please note that the Cloud Mountain Cancellation & Housing Policies remain the same & are not based on the price you choose. Click here for more information about tiered fees. Generosity Tier – $1300 plus dana offerings. Base Tier – $1105 plus dana offerings. Subsidized Tier – $910 plus dana offerings. Generosity Tier. At this tier, your sharing of your financial abundance subsidizes the reduced fees paid by others with financial hardships.This tier is set above the actual cost of hosting you on retreat (currently by $13 per day)Base Tier. This “break even” tier covers the basic costs of hosting you on retreat.This tier is set below the cost of hosting you on retreat (currently by $18 per day), but the collective donations we receive on each retreat allow us to offset the costs of hosting you at this tier. If you wish to fully cover the cost of your retreat, you may offer a donation of $18 times the number of days of your retreat.Subsidized Tier. This tier is set below Cloud Mountain’s actual costs (currently by $33 per day) and is intended to assist people experiencing financial hardship. Please exercise honor and integrity in choosing this tier and select it only if you are experiencing genuine hardship.Please choose the subsidized tier if you are applying for a scholarship.Two Avenues of Financial Assistance Available*Subsidized Rate Eligibility: You may request the Subsidized fee level if you: 1) you are experiencing financial hardship AND 2) you fall into one of the demographic categories listed below. We recognize that certain groups, including but not necessarily limited to those noted below, can face a heavier burden of financial challenges and issues of wealth inequality than others in our society. Please check all boxes that apply to your situation if you are experiencing financial hardship and wish to request the Subsidized rate. Scholarship Assistance: Anyone at all experiencing financial hardship for any reason can request scholarship assistance. The usual scholarship amounts offered fall between 10% – 50% of the Subsidized fee. To request scholarship assistance, please scroll down to complete the scholarship request process. Student Recipient of Medicaid or Social Security Disability Income Retiree on a limited income Experiencing unemployment and have less than six months of savings Member of historically marginalized populations – BIPOC / LGBTQ+ Public school teacher / community organizer / nonprofit sector employee / social services employee Full-time caregiver Single parent of children under 18 Minimum wage earner This field is hidden when viewing the formSubsidized Fee qualification (copy all checkboxes for DB) SCHOLARSHIPSWould you like to apply for a scholarship for this retreat?*Clicking yes will open the on-line scholarship application. Scholarships are awarded on the basis of financial need only and offer up to a 50% discount off the full retreat price. Please choose the subsidized tier price if you are applying for a scholarship. Yes No ONLINE SCHOLARSHIP APPLICATIONIf we are unable to approve you for scholarship assistance for any reason, we place your materials on hold while we can contact you to see how you wish to proceed around registering. If you decide not to register under those circumstances, you will not have committed to the retreat and may easily withdraw your registration. Please respond to the following questions and briefly state the reason why it would be a financial hardship for you to attend this retreat without this financial assistance. Scholarship Fund*From which of the following Scholarship Funds are you requesting scholarship assistance? General Scholarship Fund People of Color Scholarship Fund Young Adults Scholarship Fund Application Information*What is your monthly income? What are your approximate monthly expenses? Are you currently employed? Are you a homeowner? Describe your household (e.g., spouse/partner, housemates, etc.)? Please be detailed enough so that we can get a good sense of your financial situation.Requested Scholarship Amount We ask you to kindly request only the amount that will allow you to attend retreat. It is our wish to extend the scholarship fund to all participants in need of financial assistance, and your financial candor is appreciated in helping make this possible. Please also note that some level of personal financial contribution is asked of each individual. If you are receiving scholarship assistance from other sources, the financial aid we offer may be adjusted to accommodate for this. Scholarships are awarded in amounts between 10% and 50% of the full retreat cost. This policy varies for retreats longer than 12 days in length, so please check with the Cloud Mountain office before applying for scholarship on a longer retreat. Requested Scholarship Amount*Please select your requested scholarship amount below: 10% of the full retreat cost 25% of the full retreat cost 50% of the full retreat cost DONATIONSWould you like to offer a donation to Friends of Cloud Mountain at this time?*Friends of Cloud Mountain is a 501 (c)(3) non-profit organization. Your contribution is fully tax deductible to the extent allowed by law. Yes No What program would you like to designate your donation to?* General Donations Nuns Initiative Sleeping Lodge Fund Accessible Housing Fund Meal Dana Staff Dana People of Color Scholarship Fund Young Adults Scholarship Fund (ages 18-35) Teacher Relief Fund Which meals would you like to offer Dana for?* Breakfast – $100.00 Lunch/Brunch – $125.00 Dinner – $75.00 Breakfast and Lunch – $225.00 Lunch and Dinner – $200.00 Breakfast and Dinner – $175.00 Full Day – $300.00 Would you like to offer meal dana anonymously?* Yes No How would you like your meal dana dedication to read?If you do not wish to provide a special dedication, we will use one of our standard dedications. Depending on whether the offering is anonymous or not, the dedication board would read, “This meal has been offered by Jane/John Doe,” or, “This meal has been offered by an anonymous friend (present)/(not present) on this retreat.” In this case, please leave this field blank.On what day of the retreat would you like to offer meal dana?If you have no specific date in mind, please leave this field blank. MM slash DD slash YYYY What amount would you like to give to Cloud Mountain today?* $50 $75 $100 $250 $500 Other Other donation amount:* This field is hidden when viewing the formDonation Amounthidden on form but appears on PDFPAYMENT SUMMARYPlease review this information before submitting your form. Retreat ChoiceRetreat Cost $0.00 This field is hidden when viewing the formRetreat Costappears on PDFBedding Packet Rental Fee $0.00 Donation Amount $0.00 This field is hidden when viewing the formWashington State Sales/Lodging Tax $0.00 This field is hidden when viewing the formWashington State Sales Tax $0.00 Washington State TaxBalance Due (after $500 Initial Deposit)An initial deposit of $500 will be charged at the time of registration. Any remaining balance will be charged on the due date posted in the retreat description. Price: $0.00 Balance Due (after $1000 Initial Deposit)An initial deposit of $1000 will be charged at the time of registration. Any remaining balance will be charged on the due date posted in the retreat description. Price: $0.00 This field is hidden when viewing the formDonation Amountdatabase use AND appears on PDFThis field is hidden when viewing the formBalance Duedatabase use / appears on PDFRequested Scholarship Amount Price: $0.00 TOTAL PAYABLETotal Amount Authorized: $0.00 Includes the cost of your retreat (or initial deposit) and any donations offered. Any remaining balance will be charged on the due date posted in the retreat description.This field is hidden when viewing the formCalculated TotalThis hidden field copies the total amount. Payment Method is bypassed if this field = 0.00 (no fee retreat + no donation)PAYMENT METHODOnline registration is through credit or debit card (Visa or Mastercard only). To register by check or money order, please print out the form summary that will be emailed to you after submission and mail it in along with payment to the Cloud Mountain office. If you choose to pay by mail, your space will be held for 10 business days from receipt of your online form to allow your mailed payment to reach us. After 10 business days your space will be released if your payment has not arrived. If you are joining the waitlist for a retreat, you do not need to provide credit card payment information or a check. Instead, select the Pay By Mail option to submit your form to us without payment information at this time.Select payment method:* Pay Online Pay by Mail CREDIT CARD INFORMATIONAuthorization* I authorize Cloud Mountain to process the payment of the amount above. Any remaining balance will be charged on the due date posted in the retreat description. Credit Card* MasterCardVisaSupported Credit Cards: MasterCard, Visa Card Number Month010203040506070809101112 Year20252026202720282029203020312032203320342035203620372038203920402041204220432044 Expiration Date Security Code Cardholder Name Billing Address* Same as above Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country This field is hidden when viewing the formSection BreakDo you wish to receive Cloud Mountain’s e-newsletters and occasional retreat updates?*Cloud Mountain never sells or shares your personal data, with the sole exception of providing your contact information to the teacher(s) leading your retreat. Yes No Photo Release*Photos taken while you are at Cloud Mountain may be published to our website, social media, or other material. Do you consent for images and/or videos of you to be used for promotional purposes? Yes No Other CommentsAfter submitting this registration form, a summary will be sent to your email address. Please print out the form and send along with your check or money order to: Cloud Mountain Retreat Center, 373 Agren Road, Castle Rock, WA 98611. EmailThis field is for validation purposes and should be left unchanged.