Mindfulness Facilitator Certification

* These fields are required

1 Welcome

Please fill out your details and press Continue.

First Name *

Last Name *

Email *

Please be sure your email address is correct.

Confirm Email Address *

Daytime Phone Number *

Send me a reminder if I don't register today!

Continue

2 Price

Sorry! Your selection is no longer available.

Select a price.

Sold Out

$3,400.00 – Package Includes: Tuition and 2 Virtual Weekend Retreats$3,400.00 $3,400.00 – Package Includes: Tuition and 2 Virtual Weekend Retreats

Sold Out

$3,700.00 – Package Includes: Tuition and 2 In-Person Weekend Retreats as a Commuter$3,700.00 $3,700.00 – Package Includes: Tuition and 2 In-Person Weekend Retreats as a Commuter

Sold Out

$3,960.00 – Package Includes: Tuition and 2 In-Person Weekend Retreats with a Private Room and Shared Hall Bath$3,960.00 $3,960.00 – Package Includes: Tuition and 2 In-Person Weekend Retreats with a Private Room and Shared Hall Bath

Sold Out

$4,600.00 – Package Includes: Tuition and 2 In-Person Weekend Retreats with a Private Room and Private Bath$4,600.00 $4,600.00 – Package Includes: Tuition and 2 In-Person Weekend Retreats with a Private Room and Private Bath

Continue

3 Participant Details

Preferred Name	Name you would like us to call you and use on your name tag
What are your pronouns?	Learn more about why we ask your pronouns here. Ex: She/Her, He/Him, They/Them
Birth Date *
Address *
Address 2
City *
State/Prov. *
Zip/Postal *
Country *
Current Employer *
Current Occupation *
Emergency Contact: Name *
Emergency Contact: Phone *
Any dietary requirements or food allergies
Please share any medical/mental health information you’d like us to know and/or any additional support you might need during this program.

Continue

4 About You

Please limit your responses to no more than 200 words.

Starting Point: How do you currently define mindfulness? *
Self-Care: How do you currently practice mindfulness and/or self-care, if at all? *
Modalities: There are many ways to practice mindfulness. Can you please share about your modalities and experience with mindfulness and/or other contemplative practices? *
Personal Practice: Please describe your personal meditation and/or movement (yoga, tai chi, etc.) practice. *
Intention: How do you intend on using your MFC training (some people want to teach and some want to deepen their personal practice). *
Community: What populations or communities do you feel drawn to working with? *
DEI: Have you participated in any DEI Trainings? If so, please list the trainings and describe the impact this learning has had in your life. If not, what are you curious to learn about this topic? *	DEI stands for Diversity, Equity, and Inclusion
Why CBI?: Please tell us why you are interested in participating in MFC. *

Continue

5 Demographics

The following questions are completely optional. All of your individual information will be aggregated anonymously for reporting purposes and to help us understand representation and inclusivity at Copper Beech Institute. We acknowledge that this language is continually evolving, so if there is new/better language for any of these identities that you feel should be included, please contact us at info@copperbeechinstitute.org.

Do you self-identify as BIPOC?	Yes BIPOC No BIPOC I prefer not to answer
Describe your ethnic group or race:
What is your gender?	Female Male Non-binary Transgender Two Spirit I prefer not to answer
A gender not described above:
What is your sexual orientation?	Asexual Bisexual Heterosexual Homosexual Pansexual I prefer not to answer Other
A sexual orientation not described above:
Are you a current or former member of the U.S. Armed Forces, Reserves or National Guard?	Yes No I prefer not to answer

Continue

6 Agreements

Mindfulness Facilitator Certification Policies *	I acknowledge that I have read the Mindfulness Facilitator Certification Policies in their entirety, and I agree to abide by all policies as outlined under the MFC Policies section.CLICK HERE TO READ THE MINDFULNESS FACILITATOR CERTIFICATION POLICIES
Risk Acknowledgement and General Release *	I accept the Risk Acknowledgement and General ReleaseCLICK HERE TO READ THE RISK ACKNOWLEDGEMENT AND GENERAL RELEASE
Inclement Weather Policy *	I agree to the Inclement Weather Policy.CLICK HERE TO READ THE INCLEMENT WEATHER POLICY
Image Consent *	I acknowledge that I have read and agree to the terms of the "Image Consent" below.PLEASE READ IMAGE CONSENT POLICY HERE: I grant permission to Copper Beech Institute to take photographs and/or record digital media of me for use in promotional materials. These materials might include printed or digital products. I authorize the use of these images and recordings.
Email and Contact Consent *	I consent to my email being shared with facilitator(s) & being contacted by them directly.

Continue

7 Tell Us More

Email newsletter (Not required)	Please send me the Copper Beech e-newsletter
How did you hear about Copper Beech Institute? *
How did you hear about this particular program? *

Continue

8 Discount Code

Discount Code

Continue

9 Donate

Please enter your donation amounts below

$	Our Community Canopy As a nonprofit retreat center, our mission is to share the practice of mindfulness with as many people as possible. We are grateful for your generosity in helping make this possible.

Continue

10 Payment

All deposits are non-refundable. On or before February 8, 2025, participants will have the option to cancel their registration and receive a refund of the amount paid, minus a 25% non-refundable deposit of the total program price. On or after February 9, 2025, no refunds will be permitted for any reason and all program payments must be paid in full no later than 15 days prior to the last day of the program.

Sub Total	$0

Taxes	$0

25% Deposit	$0
	$0 next payment date * last payment amount will be $0

Pay	Choose to pay a deposit or the full amount right now.

Due Now	$0 $0

	You will be asked for credit card details in the next step. Click the button below to continue.

Continue