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General Information

First Name (Legal)^*

Last Name (Legal)^*

Spiritual Name (if different)

Email^*

Phone Number^*

Country^*

Date of Birth^*

Format: Day-Month-Year

Age^*

Please choose your age. If you are registering for someone who is 16 or 17, please fill out our Alumni Gathering Registration Form for Minors, located on the website: www.miripiriacademy.org/alumni-gathering

Gender^*

Dietary Restrictions

Our meals are lacto-vegetarian. Please let us know if you have any dietary allergies or restrictions.

Medications

Please list any medications that you are on. Please bring an extra 1 week supply for unforeseen travel delays.

Roommates

Please list the name(s) of other attendees you'd like to room with.

Emergency Contact Name^*

Emergency Contact Phone Number^*

Emergency Contact Email^*

Emergency Contact Relation^*

Relationship to the attendee

Camp Interests

Which of the following activities appeals to you most?^*

Golden Temple seva Dharmsala trip Sports Competitions Amazing Race Kundalini Yoga classes Long meditations Aquarian Sadhana Other Seva Activities

Check all that applyl

What other places to visit/activities would you like to do?

Are there any specific yoga or meditation topics you'd like to have classes on?

Covid

Covid Vaccine and Mask Protocol^*

We do not require anyone to be vaccinated or wear a mask while on campus.

Attendees should bring masks in case we visit any locations that do require masks to be worn.

Payment

Refund Policy^*

I understand the refund policy

A full refund is payable up to 30 days before the start of event, and is 75% refundable less than 30 days before the start of the event.

Fees

Mandatory Fees
	Alumni Gathering Registration	108
	Total	108.00

Alumni Gathering Registration

General Information

Camp Interests

Covid

Payment

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