Dying into Life Application - Community for Deepening Practice

Dying into Life: Registration

May 12 – Oct. 27, 2023

Three Fridays per month
*This is a live course and is not intended as a drop-in experience. Please be sure you can commit to the class dates before registering.

Full course details

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Choose your price (USD):
$1070 (Lend a hand) / $890 (Base) / $715 (Need a hand)

Course fee is payable monthly or at one time. If you opt for monthly payments, a $250 deposit will be required upon application.

Step 1 of 6

Applicant Information
Name*
First Last
What are your personal gender pronouns?
he, his; she,hers; they,them; etc.
Are there any other personal or social identities you'd like us to know about?
race, ethnicity, first language, disability status, affectional orientation, etc.?
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
How did you hear about the this course? Please be as specific as possible.*
Email*
Phone*
Occupation

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MSC In Your Life
The pre-requisite for this course is completion of the full MSC program. When did you graduate from your MSC course?*
Please provide the dates of your MSC course completion and your teacher names. Short courses, intro workshops, Core Skills, reading the MSC Workbook, etc. are not pre-requisites for attending Dying into LIfe.
If you are a CDP graduate, welcome back! When did you graduate from the CDP?*
Please provide your cohort number if you know it and/or teacher names.
Why are you interested in participating in this program?*
Please note that Dying into Life is designed for personal growth and development; it is not a replacement for therapy or legal advice.
Are you or someone you are caring for experiencing a life-limiting illness right now?*
If you wish, please share a bit about that here. (Optional)
To help the teachers tailor teachings to the group's needs, can you please share a bit about your relationship with death?*
You may wish to speak to experience with hospice, intensive caregiving, or other first-hand experience with life-limiting illness. If you don't often think of death, or it's very new territory for you, that's helpful for us to know as well.
Can you please tell us a bit about your mindfulness and self-compassion practice?*
For example, how often do you meditate, both formally and informally? What are some of your strengths with your MSC practice, and what are some of the challenges?
Exploring the topic of mortality can be both rich and potentially activating. Please indicate what support outside of class you have in place for yourself regarding this.*
This can be professional and/or personal support.

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Personal Health Background
How would you describe your physical health?*
- Excellent
- Good
- Fair
- Poor
Are you currently in psychotherapy?*
- Yes
- No
If you wish to tell us any details, please do so.
Are you currently taking medication, for physical or mental health reasons, that may affect how you feel from one week to the next?*
If you have any special learning needs for which you request accommodation, please share those needs here.
Is there anything else that would be helpful for the teachers to know at this time?

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Waiver of Liability
I, , understand that Community for Deepening Practice classes are online educational programs designed to support personal practice after I have completed the complete MSC course.

The CDP is a group compassion skills training program, not group therapy, and it is designed to teach participants the tools needed to develop and cultivate a mindfulness and self-compassion practice. I understand that the CDP does not take the place of personal therapy. The Community for Deepening Practice assumes the same guidelines.

I voluntarily agree to participate in Community for Deepening Practice classes. I can choose to withdraw from the Community for Deepening Practice without any penalty and I am aware that the course fee is non-refundable. If I am paying by installments, then I am still liable to finish paying these.

If I wish to no longer receive notifications from the Community for Deepening Practice, I will request that my details will be removed.

I understand that I am required to provide details of my support system, and it is my responsibility to contact them if I feel the need should backdraft or difficult emotions arise.

I understand that the teachers are not expected or able to provide medical and/or psychological care.

I understand that if I am intoxicated with alcohol and/or non prescribed/prescribed drugs then I am not permitted to take part in Community for Deepening Practice.

I further understand that participation in the Community for Deepening Practice is at the discretion of the teachers at all times. If, in the opinion of the teachers, I am unable to continue to participate productively in Community for Deepening Practice, I may be asked to leave.

Any costs incurred for health services are my responsibility and not the responsibility of the teachers. I hereby assume all responsibility for my own equipment required to attend the online sessions.

I understand that Community for Deepening Practice is not aimed at providing any requirements for MSC Teacher Training or to be a replacement for MSC.
By signing below, I confirm that I have read and agree with all sections of the preceding Waiver of Liability. I also agree that I am of legal age.
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Check Out
For maximum accessibility, Dying into Life is offered on a choose-your-price basis:
$1070 USD (lend a hand)
$890 USD (base price)
$715 USD (need a hand)
Upon admittance, how do you wish to handle your course fee?*
- All at one time, prior to the course
- Monthly payments via auto pay (+$50)
Please select the course fee (USD) that best represents your ability to pay.*
- Lend a hand - $1070
- Base fee - $890
- Need a hand - $715
Please select the course fee (USD) that best represents your ability to pay.*
- Lend a hand - $1070
- Base fee - $890
- Need a hand - $715
Total due today (USD):
$0.00
Credit Card
Card Details
Cardholder Name
Comments
This field is for validation purposes and should be left unchanged.

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Note: This course is contingent on a minimum enrollment. In the event that the course is cancelled, you’ll receive a full refund of your registration fee. We will contact you prior to the start of the course if it is cancelled due to insufficient enrollment. Otherwise assume the class is going forward.

Dying into Life: Registration

May 12 – Oct. 27, 2023

Step 1 of 6

Applicant Information

MSC In Your Life

Personal Health Background

Agreements

Waiver of Liability

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