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Summer Zen Sesshin
Pre-arrival Form
JUNE 11-16: Summer Zen Sesshin
"
*
" indicates required fields
Name
*
First
Last
Phone
*
Email
*
Disclaimer: By providing us your email, you will be added to Mercy Center's email community where you'll receive relevant content and offers. By signing up, you agree to Mercy Center's
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and consent to its Privacy Policy. You can easily unsubscribe at any time. To opt out of joining Mercy Center's email community, please check the box below.
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Emergency Contact Name
*
First
Last
Emergency Contact Phone
*
Emergency Contact Email
*
Note: Emergency contact information will be used for emergencies only.
Meals Information
Our Food Services department is committed to serving delicious, healthy food and strives to offer daily choices for people with a variety of dietary preferences.
• We
cannot
support specific dietary restrictions for individuals.
• If you have a food allergy or intolerance, you are welcome to supplement your meals by bringing some of your own food items.
• There is refrigerator and microwave on each bedroom floor available for guest use.
• Please label food items with your name and the dates of your retreat.
Type of Meals:
Please choose one type of meals you wish to eat during your stay.
Meal Type Choice
*
Regular Menu Only (meals including meat, fish, or chicken, sometimes vegetarian)
Vegetarian Only
Vegan Only
N/A (not staying for meal(s))
Physical Limitations: Do you have any physical limitations or other conditions that you would like to share with us?
No Limitations
Yes, I have the following limitations
We have a limited number of rooms to help support our guests with physical limitations.
Special Needs
Smoke Free Campus
Please note that we are a smoke and vape free campus.
Questions/Comments
Floor Captain Volunteer
I am willing to be a volunteer floor captain and assist guests in case of emergency. I understand a brief training will be provided when I arrive at Mercy Center.