Mt. Equity Event Registration Form

Please enter the following information:

Name:
Address:
Age:
Phone Number:
Email Address:
Emergency Contact and phone number:
Occupation/Interest:
Title and Date of event you wish to register for:
Day of Arrival/ Day of Departure for those sojourning:

Briefly describe your past experience with Zen or other forms of meditation including the names of the teacher(s) you meditated with, the name of the meditation center, how many months or years you’ve had a meditation practice, and any dietary restrictions if applicable.

Please describe any other information that is pertinent to your situation.

Suggested Donations for Events:

	1/2 Day of Mindfulness	$12 (MEZ friend $10)
	Day of Mindfulness	$25 (MEZ friend $20)
	Stay over for Women	$80 (MEZ friend $50)
	Full Sesshin	$120 (MEZ friend $85)
	Sat/Sun Sesshin	$95 (MEZ friend $70)
	Full Day Sesshin	$50 (MEZ friend $40)
	Long Sesshin	$330 (MEZ friend $260)
	Year-End Sesshin	$220 (MEZ friend $160)
	Sojourner	$40 per day

*Thanks to the generosity of past donors we are able to have retreats available to you today. Consider your donation in a similar light

Mount Equity Zendo is a 501(c)3 religious organization. All donations made beyond the suggested donations are tax deductible, and no one is turned away for lack of funds. While food donations for MEZ are also welcome, please consider an additional donation of non-perishable food that we will make to a local food bank.