Retreat Registration Form
To register for a retreat at Tara Mandala, we ask that you fill out this and any attached forms and send them back to us via e-mail (info@taramandala.org), mail at PO Box 3040, Pagosa Springs, CO 81147 or via fax at 970-731-4441.

Retreat Name:
Annual Family Comunity Retreat
July 26 - August 2, 2007

Your Name:________________________________________________ E-mail:___________________________

Address:___________________________________________________Phone:___________________________

City:__________________________________ State:________ Zip:_____________ Country:________________

How did you hear about Tara Mandala?
Mailing list Ad Flyer Program Guide Web Word of mouth Other _________________


Course Price:
$500 per adult
$270 per child (ages 6 - 12)
$340 per teen (ages 13-17)

Sangha Member Price (15%/10%):
$425/$450 per adult

*Tent rental?___ Nights___ x $20 = $ ___________
*Shuttle from Durango? $50 each way = $________
*Tent/shuttle reservations need to be made at least two weeks prior to the retreat.
I would like to join Sustaining Sangha. Amount $_______
(Pledges are tax deductible.)
Check one: Monthly Annually One-Time

Retreat Total (chosen from sliding scale) $________________
Tent Rental $________________
Shuttle $________________
Donation (not dana) $________________
Tax Deductible Pledge Amount$________________
CEU's ($10 per course) $________________

Subtotal $________________
Early Registration* -$________________

**Total Due$________________

Total Payment $ _______________

*$25 discount for completed registrations received 30 days prior to retreat.
** Full course payment must be received at the time of registration. Tent/shuttle payments can be made at the start of the retreat.

Payment Method: Check Visa MasterCard Am. Express Money Order

Make checks and money orders payable to Tara Mandala. If using a credit card, please complete information below.

Card #:_____________________________________________ Expiration Date:_________________

Signature:___________________________________________ Date:__________________________

Name on Card:_____________________________________________________________________

Click Here to send registration to info@taramandala.org.

*Please familiarize yourself with our retreat accommodations and policies before registering for any retreat.
*If you're interested in reserving a tent at a cost of $20 per person per night, contact our office to check for availability.
*Upon the successful completion of your registration and in a timely manner before the retreat, you will receive a confirmation letter giving you instructions on check-in procedures, what to bring, and other pertinent information.
*We accept cash, checks, Visa, MC and Am Express. Full payment must be received at the time of registration.

Cancellations must be made in writing. Refund amounts (course fee minus a cancellation fee) are dependent on timing of cancellation. Cancellation received 30 days prior to retreat start date: minus $25. Cancellation received at least 10 days prior: minus $50. No refunds can be given for cancellations made less than 10 days prior.

Tara Mandala, PO Box 3040, Pagosa Springs, CO 81147, 970-731-3711, info@taramandala.org, www.taramandala.org