In-Person Zazen Attendance Agreement
Dear Friends of the Dust Bowl Dojo,

As we begin to practice in-person at the dojo, we want to make sure that precautions are taken to minimize risk while offering useful instruction and practice. This form is for any vaccinated person who wishes to attend in person and need only be filled out once per season. Those who are unvaccinated are welcome to join us via Zoom and need not fill out this form. (See the dojo calendar for Zoom links.)

Bring your vaccination card to the dojo for confirmation on the day of first attendance. Proof of vaccination is required at this time in order to attend in person, and masks, though not needed for zazen, will be worn during chanting and must be brought to the dojo.

This form must be filled out prior to attending.

Thank you for your cooperation. We look forward to practicing together safely in the dojo!

Gary Enns
Director
zen.fellowship@gmail.com 
Sign in to Google to save your progress. Learn more
First and last name. *
Email. *
Covid vaccination type and dates. *
Please share the type (Pfizer, Moderna, J&J) and date/s of vaccination here, and bring your card to the dojo for confirmation on the day of first attendance. Official proof of vaccination must be shown in person in order to practice in the dojo.
Notification agreement. *
I agree to let the director know if I experience ANY symptoms within two weeks AFTER attending zazen, so that other participants can be notified.
Required
Symptoms or diagnosis agreement. *
I agree not to participate in group practice if I experience ANY symptoms or have tested positive for COVID-19 within 14 days prior.
Required
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms