Name *

First Name

Last Name

Phone *

(###)

###

####

Emergency Contact *

First Name

Last Name

Emergency Contact Phone Number *

(###)

###

####

What days will you attend? *

Dec. 3rd

Dec. 4th

Dec. 5th

Dec. 6th

Dec. 7th

Dec. 8th

Dec. 9th

Dec. 10th

Will you need overnight accommodations? *

Yes

No

Will you need a chair? *

Yes

No

Will you need Oryoki Instruction? *

Oryoki is the zen style of serving and and eating meals. If you need instruction or would like to polish your Oryoki choreography, please check the yes box.

Yes

No

Will you be using a set of Jikoji's Oryoki bowls? (included with sesshin) *

Yes

No