Name:
Gender:
Male
Female
Age:
Address:
Best Contact phone number:
Emergency Contact Name:
Emergency Contact Phone Number:
E-mail:
Please confirm your e-mail:
Previous Sesshin Experience (If you have attended TZC sesshins before, please skip this
part of the form):
This will be my first experience attending a sesshin
I have attended sesshins with other meditation groups before, but this will be my
first experience attending a Toledo Zen Center sesshin.
Current Practice Please briefly describe your current practice (such as breath practice, shikantaza, koan study, etc.), and any
meditation retreat experience you may have.
Sesshin Participation Please help us eliminate the need to transport extra cushions
to/from sesshin that are not really needed. Please bring your own cushions, if possible.
Yes, I can bring my own zafu and zabuton.
No, I need to rely on cushions that will be transported to/from sesshin.
Sesshin Participation Sesshin is an intensive group practice, and it’s important to attend the
orientation (held the first day/evening of sesshin) and to remain throughout the scheduled retreat
period, including participating in our final group practice and helping to pack up our sesshin
supplies. If you need to make special arrangements regarding your participation, please advise us
prior to sesshin
Dietary/Health Concerns – Food at sesshin is vegetarian. List any dietary restrictions. Also please describe any serious health concerns, Psychological issues, medications or physical limitations we
should be aware of:
Opportunities to Contribute to Sesshin:
I can help transport supplies to sesshin such as zabutons, kitchen supplies, etc.
Yes, I can asisst in setting up the Zendo upon arrival.
I can bring flowers to contribute to the bouquets for the altars in the zendo and
dokusan rooms.
Financial: Financial aid is available, and no one is turned away because of financial reasons. We do ask
that if you request financial aid that you make a donation of some amount, no matter how small.
If you wish to apply for financial aid please check below and Rinsen or Do’on will contact you
to discuss the details.
Yes, I would like to request financial aid.
Financial Aid Program
Please consider making a gift of compassion by donating to the financial aid fund which is used to offset costs of providing financial aid for fellow practitioners in need.
Once you click Send Information on this screen you will have the opportunity to donate on the next page. At that time please enter the desired amount and click send payment. Thank you for your generosity.
Yes, I would like to donate to the financial aid program.
Fees and Terms
Fee for Sesshin is $230 (U.S) this includes the cost for meals and your room.
Please submit a $100.00 deposit with your application unless you are requesting financial aid.
Should you need to cancel, please consider donating your previously made payment to:
Drinking Gourd Dharma Circle
Balances are due 2 weeks before the sesshin
If you cancel 14-8 days prior the sesshin, 50.00 will be retained.
If you cancel 7-3 days prior to the sesshin, 100.00 will be retained.
If you cancel 2 days or less prior to the sesshin, all fees paid will be retained.
Comments/Questions:
Note: You are not fully registered for sesshin until your application and your payment in
full has been received. Click on the Send Information Button Below. Your application will be submitted and you will be re-directed to the payment screen. Thank you.