Sesshin Application

7 Arnold Park
Rochester, NY
14607
USA (585) 473-9180

Are you applying to the entire sesshin?

Yes
No

If not, tell us which days and times you would like to attend:

Sesshin Fee:

The full fee for sesshin is due before sesshin begins. If you are a Center member, the fee is $45/day. For non-members, it’s $65/day. For those coming part-time, the charge per block is $12/day for members and $15/day for non-members.

Each day of sesshin includes 4 blocks of sitting:

Block 1: 4:45am - 7:00am

Block 2: 9:30am - 12:30pm

Block 3: 1:30pm - 3:45pm

Block 4: 7:00pm - 9:30pm

Abbot’s Fund:

For members unable to afford the sesshin, Roshi has a fund he can use to provide assistance. If you would like to donate to this fund and help others to attend sesshin, please indicate the amount here:

Personal Information

Membership Status

Member
Non-Member

If, in a formal ceremony, you have become the student of a Zen teacher, please enter the teacher’s name:

Sesshin Experience

Have you ever attended a sesshin?

Yes
No

If yes, please list the most recent and longest sesshins you’ve attended:

Sesshin Month/Year Location Conducted By No. Days

Medical Information

Please answer the questions below in detail, even if you’ve done so for a previous sesshin.

Please list any medical conditions you have that require regular care or medication (include pregnancy, current infections, high or low blood pressure, communicable diseases or chronic headaches).

Medical Condition: Medication (if any):

Please list any hospitalizations or major surgeries you have had in the past five years:

Describe any significant problems with your back or legs:

I need to sit in a chair:

Never
Part-Time
Full-Time

If you have experienced dizziness, fainting, palpitations or shortness of breath during sitting, please describe the nature of the problem:

List any dietary restrictions or food allergies that might affect your sesshin and give some indication of their seriousness. NOTE: if you have a serious food allergy, please also contact the Head Cook directly.

Describe any other allergies (including allergies to drugs):

Please complete the following two questions if this is your first sesshin with the Rochester Zen Center or if the information has changed since you last answered these questions:

Please give details of any serious psychological problems or crises, whether or not you were treated or hospitalized:

Have you ever attempted to take your own life?

Yes
No

PLEASE NOTIFY THE HEAD MONITOR OF ANY MEDICAL OR OTHER CONDITIONS THAT ARISE AFTER SUBMITTING THIS APPLICATION

Soaking in bath or shower: The Chapin Mill Retreat Center has two communal soaking baths (a description of which is posted here). If you would like to take a bath rather than a shower, check the box, and if we can schedule you for one, we will.

Request bath
This will be my first time using the Chapin Mill bath

Rides and rooms: If coming from out of town, will you need a ride from the airport, and will you need a room at Arnold Park or Chapin Mill before or after sessin?

No, I don’t need a ride or a room.
Yes, and I will contact you later with the details.
Yes, and here are the details:

If there are any pressing circumstances, such as difficulty arranging time off from work, that would prevent you from applying to another upcoming sesshin, please explain here.

In submitting this application, I agree as follows:

  • I will finish the entire sesshin or that portion I’ve applied for.

  • WAIVER OF LIABILITY: I understand that sesshin is a period of strenuous traditional Zen training involving some 10 hours of formal meditation per day during which participants may frequently be struck with the kyosaku (encouragement stick). In accordance with this understanding and in consideration for the Center’s accepting me to sesshin, I agree that neither the Rochester Zen Center nor any of its employees, officers, trustees, or trainees - nor any person acting as sesshin monitor or otherwise supervising, overseeing, or conducting any aspect of sesshin - shall be liable to me or to any other person 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 the Center or any of the persons specified above.

    I’ve read the statement above and agree: