Jizo Sesshin

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1 Welcome

2 Price

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$380.00 – Event fee

Number of Guests:

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$280.00 – Event fee (ZCO member rate)

Number of Guests:

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3 People in your group

4 Optional Items

5 Participant Info

Dharma Name
Phone *
Address *
Address 2
City *
State/Prov. *
Zip/Postal *
Country *
Country
Age *
Dietary Needs	Vegan Gluten Free Dairy Free All our meals are vegetarian. We have vegan and gluten free options available as needed. Please use question #2 if you have additional allergies.
Dietary Notes	We are able to provide Vegan and Gluten Free alternatives. If you have other allergies, we will make sure food is labelled. Please indicate additional food allergies. Please contact us with questions
Emergency Contact Info *
Retreat practice can be physically and emotionally rigorous, please let us know any physical, mental or emotional conditions that might impact your participation. *	Please feel free to contact us with any questions or concerns
How did you hear about this program?
Are you currently taking any medications? If yes, please specify.	Please let us know exactly what kind of medication you are taking.
Allergies
Meditation Experience *	Do you have a meditation practice? How long have you been meditating?
Is this your first retreat at Great Vow? *	No Yes
Retreat Experience *	Please describe any meditation retreat experience you have
Work Skills	Please list work skills that you have (carpentry, sewing, gardening, landscaping, videography)
Pronouns you use
Which dorm assignment(s) suits your gender? If you are open to more than one type of dorm, please select all that apply. *	Female Dorm Male Dorm All-gender Dorm
Have you attended an in person weekend or weeklong meditation retreat at Great Vow or another Zen Center? If yes, please indicate the last in-person meditation retreat you attended. *	We require that everyone attending sesshin in person has prior in-person meditation retreat experience.

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6 Payment

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Guest 1		First Name* Last Name* Email*
Guest 1		First Name* Last Name* Email*