Metta Dharma Foundation

PARTICIPATION AGREEMENT AND LIABILITY RELEASE

I voluntarily agree to participate in the following Metta Dharma

Foundation activity: A residential meditation retreat at Jikoji Retreat Center, Los Gatos, CA, April 16 to April 25, 2010 taught by Richard Shankman.

Assumption of Risk. I fully realize that this activity may involve strenuous physical activities including, but not limited to, meditation, yoga, other movement activities and classes, and work (e.g., in the kitchen, helping clean the retreat center at the end of the retreat, etc.), as well as risks associated with hiking in the rural setting, including contact with poison oak and wildlife. I am also aware that this is a silent, intensive meditation retreat and that participants in such retreats may experience intense and/or unusual psychological, physical, spiritual and/or emotional states of mind and body arising from the meditation and associated retreat activities. I am voluntarily participating in these activities with full knowledge of all of the risks involved and agree to accept any risk that arises as a result of my participation.

Release of Liability. In consideration for Metta Dharma Foundation allowing me

to participate in these activities at facilities owned, rented, or otherwise

procured by the Metta Dharma Foundationand Richard Shankman, I agree that

neither I nor anyone acting on behalf of me, my heirs and/or assignees will seek

any claims including, but not limited to, lawsuits or attachment of Metta Dharma

Foundation or Richard Shankman property, its agents or volunteers or any

affiliated organizations for injury or damage resulting from negligence or other

acts, howsoever caused, by anyone working directlyor indirectly for Metta

Dharma Foundation or Richard Shankman, except for gross negligence or

intentionally acting in a manner likely to lead to my being harmed. I release

Metta Dharma Foundation and Richard Shankman from all actions, claims or

demands that I and/or anyone acting on behalf of me and/or my heirs or

assignees may have for injuries or damages I incur from my participation in

these activities, except for gross negligence or intentionally acting in a manner

likely to lead to my being harmed.

Knowing and Voluntary Execution. I have carefully read this agreement and

fully understand its contents. I am aware that this is a release of liability

and contract between myself and Metta Dharma Foundation and its affiliated

organizations and Richard Shankman.  I sign it of my own free will, knowingly

accepting my assumption of risk and the release of liability.

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Printed Name

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Signature

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Date

Please send Application form and this Voluntary Participation form with your payment to:

Metta Dharma Foundation

79 Templar Place

Oakland, CA  94618