Event Registration

Name

Address

Phone

Do you have a medical or physical condition that limits your activity or that you feel we should be aware of?

Please list any food allergies you may have

For lodging purposes, how do you identify your gender?

How did you hear about Yokoji Zen Mountain Center?

Emergency Contact

Name of your emergency contact

Phone of your emergency contact

Event Agreement and Liability

Event

Dates of Stay

I agree to attend the full schedule for the duration of my stay

(If registering for a sesshin) I agree to read and uphold the sesshin guidelines

(Please initial to agree) I agree to defend, indemnify and hold Yokoji-Zen Mountain Center, its officers, employees, agents and volunteers harmless from and against any and all liability, loss, expense (including reasonable attorneys’ fees), or claims for injury or damages arising as a result of my attendance of the above event at Yokoji-Zen Mountain Center, 58900 Apple Canyon Road, Mountain Center, CA 92561, and to reimburse Yokoji-Zen Mountain Center for any such incurred expenses.

Deposit Payment Options

Would you like to pay your $50 deposit securely online or would you like to mail a check? CheckOnline

All events that have an associated fee require this event registration form to be filled out and submitted along with a non-refundable deposit of $50.

To maintain the health of the Zen Center and to comply with county regulations, please do not plan to attend if you have had an ILI (influenza-like disease) in the seven days prior to your intended arrival.

Download the list of items to bring so you are prepared for your visit.