Zazenkai (Part-time)

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1 Welcome

2 Housing & Program Fees

	Sustaining Member
	$25.00 to $50.00 – Practicing & Supporting Members
	$27.50 to $55.00 – Affiliate Member
	$30.00 to $60.00 – Corresponding Member
	$42.50 to $85.00 – Non-Member
	$ Please enter an amount *

3 People in your group

4 Optional Items

Skip this section if you are a Sustaining Member. Sustaining Members, type the details of your registration, including rental needs and participation type, in the Participant Info "Comments or Special Needs" section below.

Linens

Select this option if you would like to rent linens.

$25.00

Oryoki Rental

Select this option if you would like to rent an oryoki set.

$25.00

Guest Housing

Select this option if you would like to request housing for the retreat.

$30.00

Select quantity

Residents & Commuters

Select this option if you will be commuting and do not require overnight accommodations.

-$30.00

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5 Participant Info

ZCLA has my personal and emergency contact information on file. *	Yes No Unsure/Wish to Update
Gender
Address
Address 2
City
State/Prov.
Zip/Postal
Country
Emergency Contact Info	Please list at least one contact with phone numbers where they can be reached during the retreat.
Medical Issues	Please describe any physical, psychological, medical, dietary, allergy-related, accessibility, or other conditions that may affect your participation in sesshin, including any symptoms you have experienced while meditating (such as headaches, dizziness, heart palpitations, or shortness of breath). If none, please write "None."
Comments or Special Needs
Email newsletter	Please send me the email newsletter
Terms and Conditions	I accept the terms and conditions.I agree to maintain a daily sitting practice from the time of this application through the sesshin. I will participate to the extent I have specified above. I understand that my physical, mental, and emotional well-being are my own responsibility and understand that practice is not a substitute for therapy. I am receiving treatment for any medical or psychological condition(s) that I have, and I have revealed all pertinent information on this form. I am capable of undertaking the rigors of sesshin at this time. I agree that neither the Zen Center of Los Angeles nor any of its employees, officers, trustees, or trainees - nor any person acting as sesshin monitor or otherwise supervising, overseeing, or conducting any aspect of sesshin - shall be liable to me or to any other person for any loss or injury suffered by me in connection with my participation in sesshin, whether or not such loss or injury is caused by any act or omission of the Center or any of the persons specified above

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6 Part-Time Participants

Select the days and blocks that best reflect your intended participation. You may choose multiple blocks.
FULL-TIME PARTICIPANTS SKIP THIS SECTION.

Which days do you plan to participate?	Sunday Monday Tuesday Wednesday Thursday Friday Saturday Please select all days you anticipate participating. Your selections help us understand your intended schedule and plan accordingly.
Sunday	Full-Time Part-Time
Participation	Dawn (5:30-7:30 a.m.) Breakfast (7:40 a.m.) Samu (9:00 a.m.) Morning (10:55 a.m.-12:15 p.m.) Lunch (12:30 p.m.) Yoga (2:30 p.m.) Afternoon (3:30-5:25 p.m.) Medicine Meal (5:40 p.m.) Evening (7:25-9:00 p.m.)
Monday	Full-Time Part-Time
Participation	Dawn (5:30-7:30 a.m.) Breakfast (7:40 a.m.) Morning (10:55 a.m.-12:15 p.m.) Lunch (12:30 p.m.) Yoga (2:30 p.m.) Afternoon (3:30-5:25 p.m.) Medicine Meal (5:40 p.m.) Evening (7:25-9:00 p.m.)
Tuesday	Full-Time Part-Time
Participation	Dawn (5:30-7:30 a.m.) Breakfast (7:40 a.m.) Samu (9:00 a.m.) Morning (10:55 a.m.-12:15 p.m.) Lunch (12:30 p.m.) Yoga (2:30 p.m.) Afternoon (3:30-5:25 p.m.) Medicine Meal (5:40 p.m.) Evening (7:25-9:00 p.m.)
Wednesday	Full-Time Part-Time
Participation	Dawn (5:30-7:30 a.m.) Breakfast (7:40 a.m.) Samu (9:00 a.m.) Morning (10:55 a.m.-12:15 p.m.) Lunch (12:30 p.m.) Yoga (2:30 p.m.) Afternoon (3:30-5:25 p.m.) Medicine Meal (5:40 p.m.) Evening (7:25-9:00 p.m.)
Thursday	Full-Time Part-Time
Participation	Dawn (5:30-7:30 a.m.) Breakfast (7:40 a.m.) Samu (9:00 a.m.) Morning (10:55 a.m.-12:15 p.m.) Lunch (12:30 p.m.) Yoga (2:30 p.m.) Afternoon (3:30-5:25 p.m.) Medicine Meal (5:40 p.m.) Evening (7:25-9:00 p.m.)
Friday	Full-Time Part-Time
Participation	Dawn (5:30-7:30 a.m.) Breakfast (7:40 a.m.) Samu (9:00 a.m.) Morning (10:55 a.m.-12:15 p.m.) Lunch (12:30 p.m.) Yoga (2:30 p.m.) Afternoon (3:30-5:25 p.m.) Medicine Meal (5:40 p.m.) Evening (7:25-9:00 p.m.)
Saturday	Full-Time Part-Time
Participation	Dawn (5:30-7:30 a.m.) Breakfast (7:40 a.m.) Samu (9:00 a.m.) Morning (10:55 a.m.-12:15 p.m.) Lunch (12:30 p.m.) Yoga (2:30 p.m.) Afternoon (3:30-5:25 p.m.) Medicine Meal (5:40 p.m.) Evening (7:25-9:00 p.m.)

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7 Meal Count

Special Diet
Food Allergies & Medical Dietary Restrictions

8 Request Dharma Training Fund

Would you like to request support from the Dharma Training Fund?	Yes, I would like to request support No, thank you
What are you requesting support for?	Please briefly describe your request and how this support will assist your practice.
Amount of support requested	The student pays as much as they can. The Dharma Training Fund provides assistance for the rest.
About your Request	Please briefly share why you are requesting Dharma Training Fund support (e.g., student, financial hardship, family responsibilities, other, or prefer not to disclose). Share as much or as little as feels appropriate. This information helps us understand your request and how the Dharma Training Fund can best support your practice.

9 Donate

$	Dharma Training Fund Support another practitioner in their practice. A gift to the Dharma Training Fund helps remove financial barriers to participation, making it possible for more people to study, sit, and awaken together.

10 Security Check

Security check

11 Payment

Discount code

Sub Total	$0

Donations	$0

Taxes	$0

50% Deposit	$0

Due Now	$0 $0

Remaining Balance	$0

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