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Registration NAME_________________________________________________________________ ADDRESS______________________________________________________________ _______________________________________________________________________ PHONE_________________FAX_________________E-MAIL___________________ I understand that there are several options for accommodations, and I choose: ____ bunk bed with air mattress
Cost: $285 ____ zendo floor Cost: $250 ____ camping in the meadow with my own tent and equipment (Note: campers will sleep in the zendo or workshop in
the case of electrical storms.) Cost: $250 I will bring: ____zafu _____zabuton (These will be supplied if are not able to bring them.) Transportation: ____ I will be driving. Please send directions. ____ I will be flying into Expected times of arrival:____________ and departure:___________ Meals and
food: ____I will bring my own oryoki bowls.
___ I will need oryoki bowls. ____I have the following food allergies:______________________________________ Other: Medical or physical conditions limiting my activity:____________________________ ____ I enclose my signed form indemnifying the Hokyoji Zen Practice Community. Payment in
full of $______ enclosed. (Make check payable to Cancellation policy: Full refund if canceling prior
to July 13, 2009. After July 13, a
$100 cancellation fee will be levied. INDEMNITY AGREEMENT I agree to indemnify
and hold Hokyoji Zen Practice Community harmless from any and all claims, actions, suits, procedures, costs, expenses, damages
and liabilities, including attorneys’ fees brought as a result of my attendance and use of space for a retreat at the
Hokyoji Retreat Center, 2646 County Road 5, Eitzen, Minnesota, and to reimburse
Hokyoji Zen Practice Community for any such incurred expenses. Signature____________________________________ Date signed__________ Print
Name__________________________________ Dates
of stay_____________________________________________________________ NOTE: PLEASE RETURN THIS SIGNED FORM WITH YOUR REGISTRATION FORM TO THE |
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