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Application for _________________________________________, sesshin in Clearwater, Florida.

If your Membership Directory information is current, print your name:_____________________________. If your Medical Information Form on file with Sensei has not changed since your previous sesshin, initial here ______.  If your medical info has changed, please attach a new Medical Information Form.
SESSHIN COSTS: Please enclose a check. Suggested payment is $50.00 per day, $40.00 per day for members. Please mail the check to Mr. Ken Rosen, 10388 Kumquat Lane, Seminole, FL 33772-7514, payable to Clear Water Zen Center. Dana (donation) for Sensei is not included. Please give generously. Having a sanctioned teacher to train with us is a great blessing and your support is needed. Please give the dana to Ken. Thank  you!

CLOTHING: In addition to a robe, please bring dark or solid-colored clothing for use during the work periods, and a set of loose pants or shorts and a plain shirt or blouse for use during the exercise periods. Please avoid bright or patterned clothing and perfumes during sesshin. BEDDING: We supply foam mats. Please bring sheets, pillow, etc. Wearing a robe is not mandatory. A few robes are available for borrowing.

Full time? ____  Part time? ______  If part time, please indicate your schedule below.
5:15 AM to 7:30 AM outdoor kinhin, sittings and chanting   Thu___ Fri___ Sat___ Sun___
Breakfast Thu___ Fri___ Sat___ Sun___ Work period Thu___ Fri___ Sat___ Sun___ 
Pre lunch sittings & Teisho Thu___ Fri___ Sat___ Sun___ Lunch Thu___ Fri___ Sat___ Sun___
After lunch sittings, chanting and exercise period Thu___ Fri___ Sat___ Sun___
Dinner Thu___ Fri___ Sat___ Evening sittings Thu___ Fri___ Sat___
Overnight stay Wed___ Thu___ Fri___ Sat___

I will finish the entire sesshin or portion of sesshin for which I have applied. WAIVER OF LIABILITY: I understand that sesshin is a period of intense traditional Zen training involving about ten (10) hours of formal meditation per day during which participants may be struck with the kyosaku (encouragement stick). In consideration for my being accepted into sesshin, I agree that neither Windhorse Zen Community nor The Clear Water Zen Center, nor any officer, trustee, or director of said Community or Group, or any person acting as sesshin monitor, or overseeing any aspect of sesshin, nor any sesshin  participant, nor the owner or tenant of the building where sesshin is conducted, shall be liable 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 any of the entities specified above.

Signature ______________________________________________  Date _________________________