Retreat as Ceremony: Mindfulness and Indigenous Presence for Wellness and Healing, A Retreat for Indigenous Peoples

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1 Welcome

2 Please Enter Your Offering Here

	$1,051.00 to $1,250.00 – This range supports others to attend; enter your specific contribution below.
	$1,050.00 – This rate is the actual cost of the retreat.
	$76.00 to $1,049.00 – This range is partially supported; enter your specific contribution below.
	$75.00 – This is the minimum nonrefundable fee and is fully supported.
	$ Please enter an amount *

3 Participant Info

Phone *
City *
State *
What is your gender pronoun? (optional)
What is your Indigenous heritage? *	Please note this retreat is only open to those who identify as Native, Indigenous, First Nations or mixed.
What is your preferred, Indigenous name?	Please use your legal name in the Welcome area above and add your preferred, Indigenous name here.
Birth Date (optional)	Knowing this helps us with housing assignments.
Do you have any physical health or mobility issues we should be aware of? *	If yes, please describe in the space provided. Please enter "no" otherwise.
Do you need to use a CPAP machine? *	If yes, please be sure to see very important CPAP information on our website under the Planning your visit Medical page. Those using CPAP machines that are powered by electricity will be assigned to either casita 3 or 4, where we have solar batteries available. You must register for a casita if you plan to use your plug-in CPAP. If you bring your own rechargeable batteries or solar power source to run your CPAP then you may choose any lodging type.
Medically Necessary Dietary Requests	Gluten Free Dairy Free Lactose free Soy Free Egg Free Nut Free Vegan, includes no Honey Vegan, eats Honey Specific Food Allergy (please explain below) Other (please explain below) If you have an allergy, please use the question below to adequately describe the nature of the allergy (for example, is the allergy anaphylactic?).
Diet Notes	Please explain any medically necessary dietary requests.
You will receive a practice discussion questionnaire two weeks before arrival. In the meantime, it is important for us to understand what supports you. Do you have any personal or psychological situations/diagnoses that would potentially require additional support or impact your retreat? *	If yes, please briefly describe the situation or diagnoses and how it might affect your retreat. Due to the remoteness of our center, this information will allow us to support your well being as fully as possible. Please enter "No" otherwise.
Emergency Contact Name *	Please include their relationship to you, e.g. sibling, spouse, parent, friend.
Emergency Contact Phone *
Have you sat a silent meditation retreat away from home before? *	Yes No This retreat is open to new and experienced practitioners. We ask this question to better understand the prior experience of participants.
Have you been to Vallecitos before? *	Yes No
What is your plan for Transportation to the retreat center? *	Shuttle Riders: Shuttle leaves ABQ airport at 2pm Mountain Time the first day of the retreat. It will make one stop in Santa Fe at 3pm on the way. If you miss the shuttle, there is no other way to the retreat center other than personal car. For departure, the shuttle will arrive at the ABQ airport at 1pm.
Which shuttle pick up location do you need?	Albuquerque Airport (2pm departure opening day) Hotel Santa Fe (3pm departure opening day) Please provide this information at least 1 week prior to the start of the retreat.
Comments or Special Needs
Cancellation Policy *	I have read and understood the cancellation policy.For this particular retreat, there is a $75 nonrefundable deposit fee.
Terms and Conditions *	I have read and understood the terms and conditions for using this site.Please read the terms and conditions.

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4 Donate to Vallecitos and Support Accessibility

$	Donate to Vallecitos and support accessibility. Supporting others to be able to attend retreat is only made possible through the generous support of donations. Please make a donation to help us sustain Vallecitos and a robust scholarship fund. Thank you!

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