A 3-day meditation retreat
Zoom & In-person

Wednesday, April 5 (eve.) – Saturday, April 8
(REGISTER BELOW)

Led by Sensei Darla Myoho Fjeld

RETREAT INFO

Click here to view schedule.

In-person participants:

Click here to view fee structure.

DEADLINE TO REGISTER IS WEDNESDAY, MARCH 29.

In-person participation is limited. Please register early to guarantee a seat in the Zendo.

Returning in-person participants, if ZCLA already has your current Emergency & Medical Information on file: Click here to register.

Zoom Participants:

DEADLINE TO REGISTER IS WEDNESAY, APRIL 5 @ 9 a.m.

Click here to register.

Members: $40/Day; $120/Fulltime

Non-Members: $60/Day; $180/Fulltime

EMAIL TO ALL PARTICIPANTS WILL GO OUT THE MORNING OF WEDNESDAY, APRIL 5.

(If you have concerns about payments or any other questions, please contact programsteward@zcla.org)

*Non-members and new members: Attending an in-person “Introduction to Zen Meditation Class” or Beginner’s Wednesday offering is a prerequisite for attending all onsite activities.

APPLICATION

Participant Contact Information

First Name *

Last Name *

Email *

Phone

Address *

Address Line 1

Address Line 2

City

--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Sesshin Information

Will you attend via Zoom or in-person? *

• on Zoom
• in-person at ZCLA

Participation type? *

• Full time
• Part time

ZCLA Member? *

• Yes
• No

If no, would you like to attend a sitting period prior to attending sesshin?

• Yes
• No

Select the retreat you are applying for:Beginner's Mind Sesshin (2/15-2/18)March Zazenkai (3/15-3/16)Buddha's Birthday Sesshin (4/4-4/7)May Peace Prevail Sesshin (5/22-5/26)June Zazenkai (6/28-6/29)Just Summer Sesshin (7/21-7/28)August Zazenkai (8/23-8/24)Tangaryo (9/14)Autumn Wind Sesshin (10/13-10/20)November Zazenkai (11/8-11/9)Rohatsu Sesshin (12/6-12/15)Year End (12/27-12/30)12 Step and Zen Buddhism Workshop (Dates TBD)

Expected Arrival Time *

Date

Time

Expected Departure Time *

Date

Time

Bringing a car? *

• Yes
• No

Room Assignment Information

Your housing assignment will be made using the information on this form. It is important that you clearly state any accommodations you may require in the "additional notes" section.

Do you need housing? *

• Yes
• No

Gender:

• Male
• Female
• Nonbinary
• Prefer Not to Disclose

Okay with a Roommate:

• Yes
• No

We will do our best to accommodate requests for single rooms, but may have to assign roommates depending on the number of participants.

Please type any additional notes regarding your room needs:

Do you have mobility issues that make walking up and down stairs difficult? Do you snore loudly?

Previous Practice Experience

REQUIRED FOR NEWCOMERS

Have you sat sesshin before?

• Yes
• No

If yes, briefly describe your previous experiences including practice centers, name or sesshin leader, dates and number of days:

Please describe your current practice:

Are you currently studying with a Dharma Teacher?

• Yes
• No

If yes, please detail:

Emergency Contact Information

Please list at least one contact with phone numbers where they can be reached during the retreat.

Emergency Contact Name *

First

Last

Relationship

Day Phone *

Evening Phone *

Email *

Emergency Contact Name

First

Last

Relationship

Day Phone

Evening Phone

Email

Medical Information

Answers to the following questions are necessary to help determine whether or not participation in a sesshin will aggravate a serious physical condition, endanger a participant's health, or affect the smooth functioning of the sesshin. Therefore, it is extremely important that all information be complete, current, specific and clearly stated.

Have you recently had symptoms of headache, dizziness, palpitation, or shortness of breath associated with practicing meditation? *

• Yes
• No

If yes, please specify:

Are there any current physical, psychological, medical or other conditions that may affect your participation in sesshin? *

• Yes
• No

If yes, please specify:

Do you have any dietary restrictions? *

• Yes
• No

If yes, please specify:

Do you have any allergies? *

• Yes
• No

If yes, please specify:

PLEASE NOTIFY PROGRAM STEWARD, MYOKI, OF ANY MEDICAL OR OTHER CONDITIONS THAT ARISE AFTER SUBMITTING THIS APPLICATION

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.

I've read the statement above and agree: *

• I Agree
• I Disagree

Phone

Submit