Crestone Retreat Application for In-Person Attendance

Application for those wanting to attend Crestone in-person retreat

Name(Required)

First Last

Home Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email(Required)

Mobile Phone(Required)

Address traveling from, if it is different from home address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

How will you travel to Crestone?(Required)

Airline

Train

Auto

Other

A Covid vaccination is required

Covid Vaccination Card File Upload(Required)

Upload a copy of your official vaccination card

Max. file size: 128 MB.

We ask that everyone observe extreme caution while traveling. Are you willing to follow all precautions while traveling to Crestone including social distancing wherever possible and continuing to wear a mask indoors at all times?(Required)

YES

NO

Will you be traveling and attending the retreat with a partner or other family member who has been in your safety pod?(Required)

YES

NO

Partner/Family Member’s Name

This will allow us to plan for you to sit next to each other in the chapel rather than social distanced.

There are not any prerequisites for the retreat. Please list all the retreats with Lama Alan that you have attended (in-person or online) in the last three years .

Emergency Contact Information

Emergency Contact Name(Required)

First Last

Relationship to you

Emergency Contact Email Address(Required)

Emergency Contact Phone Number(Required)

Emergency Contact Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

This field is for validation purposes and should be left unchanged.

Crestone Retreat Application for In-Person Attendance

A Covid vaccination is required

Emergency Contact Information

Title