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Retreat Registration Application

Special Vipassanā Retreat from March 1 to March 30, 2025

With Sayagyi Daw Vimalanani

I, the undersigned, would like to enroll in the Special Vipassanā Retreat at TMC as follows:

Number of Nights
15 nights - February 28 (5pm-9pm) March 15 (before noon)
15 nights - March 15 (5pm-9pm) March 30 (March 31 the latest)
30 nights - February 28 (5pm-9pm) March 30 (March 31 the latest)
Age Group
Gender
Male
Female
Monk
Nun

Emergency Contact

Health Information

Retreat Fees ($30 per day)

Payment
Cash
Check (check payable to TMC)
Zelle (tmc.zelle@tathagata.org)
Paypal

For Health Safety

I hereby certify that the information provided in this application is accurate to the best of my knowledge. I understand that Tathāgata Meditation Center is a non-profit organization and the Special Retreat is organized

solely for the benefit of meditators like myself. Therefore, I waive Tathāgata Meditation Center and its staff from all liabilities while I am attending the Special Retreat at this center. In addition, I will fully observe the rules and regulations of Tathāgata Meditation Center especially those for the Special Retreat including COVID 19 requirements. Should I break the rules and regulations, the retreat coordinator(s) could terminate

my participation at any time without refunding my retreat fees.

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Tathagata Meditation Center

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