Chicago Bultasa Buddhist Temple will hold temple stay from August 9, 2010 to August 13, 2010.  The last day of registration is July 31, 2010. Because the spaces are limited, it is first come first served.  The age range is  from 13 to 39 year old. Those over minimum age requirement can participate alone or with a parent or guardian.

For more detailed information, please refer to information below.

불타사에서는 다음과 같이 템플스테이를 개최합니다.  참가 대상은  중학생부터 30대 중반까지이며 종교, 언어, 국적에 상관없이 누구나 참여할수 있습니다.


대한불교 조계종 미중부승가회 주최 불타사 템풀스테이
Sponsored by the Jogye Order of Korean Buddhism in Mid-North America

1. Dates 기간: August 9, 2010 Monday, - August 13, 2010 Friday
                            4 nights & 5 days
 

2. Location 장소: Chicago Bultasa Buddhist Temple                                     
                                     4360W. Montrose Ave Chicago, IL 60641

 3. Participants 참가대상: Students of College, Graduate School, Junior & High School,  

                                                  Po. Dr. to Mid 30s

 4. Fees 참가비 : Free but Donations accepted from either participants or parents
 

5. Registration 등록: Written Participation Form required (Bultasa’s Form)

                              등록 마감일 Registration Deadline: July 31^th, 2010
 
6. Contact 연락처: Program Director: HyeonSeong Sunim: 773) 286-1551,  

                                                                   bultasa@gmail.com

                                       Program Coordinator: Hana Yi : 847)849-7098,

                                                                    333m333@gmail.com

             Fax:(773)282-2663

7. Room & Board Provided 숙식:  무료 Bring your sleeping bag, pillow, tooth brush and                                                                    towel, etc

From 90/94 Highway East/South (from Chicago downtown, Michigan or Indiana)
 ( It is about 8 miles from Chicago downtown to the temple)
1 Head  90/94 Hwy North/East
2 Take Exit 43D for Kostner Ave: 0.2 mile
3 Turn right at N Kostner Ave : 0.2 mile
4 Take the 2nd right onto W Montrose Ave
    Destination will be on the left
**For required ducuments, please download attached files from the bottom of this page or print below forms. 템플스테이 양식은 이페이지 제일 아래에서 파일을 다운 받으시거나,  아니면 아래 내용을 인쇄하여 제출해 주세요.
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Temple Stay 2010 Application Form

Applicant Information (지원자 정보)

Emergency Contact (긴급 연락처)

My child, _______________________ has my permission to attend the 2010 Summer Temple Stay on Aug. 9 – 13, 2010 at Chicago Bultasa Buddhist Temple & Zen Center.

4360 W Montrose Avenue Chicago, IL 60641  Tel. 773) 286-1551, Fax 773) 282-2663, Email:bultasa@gmail.com

www.bultasa.org

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Chicago Bultasa Buddhist Temple

Liability/Consent Form

In consideration for being accepted by Chicago Bultasa Buddhist Temple for participation in Chicago Bultasa Buddhist Temple  sponsored activities we (I), being 21 years of age or older, do for ourselves(myself) (and for and on behalf on my child-participant if said child is not 21 years of age or older) so hereby release, forever discharge and agree to hold harmless Chicago Bultasa Buddhist Temple  and the elders thereof from any and all liability, claims or demands for personal injury, sickness or death as well as property damages and expenses, of any nature whatsoever which may be incurred by the undersigned and the child-participant that occur while said child is participating in the above described trip or activity.

Furthermore, we, (I) [and on behalf of our (my) child-participant if under the age of 21 years old] hereby assume all risk or personal injury, sickness, death, damage and expense as a result of participation in recreation, food, and lodging for this participant.

The undersigned further hereby agrees to hold harmless and indemnify said temple, its elders, employees and agents, for any liability sustained by said temple as the result of the negligent, willful or intentional acts of said participant, including expenses incurred attendant thereto.

We (I) authorize an adult, in whose care the minor has been entrusted, to consent to any X-ray examination, anesthetic, medical, surgical or dental diagnosis or treatment, and hospital care, to be rendered to the minor under the general or special supervision and on the advice of any physician or dentist licensed under the provisions of the Medical Practice Act on the medical staff of licensed hospital, whether such diagnosis or treatment is rendered at the office of said physician or said hospital.

The undersigned shall be liable and agree(s) to pay all costs and expenses incurred in connection with such medical and dental service rendered to the aforementioned child pursuant to the authorization.

Should it be necessary for our (my) child to return home due to medical reasons or otherwise, the undersigned shall assume all transportation costs.

The undersigned does also hereby give permission for our (my) child to ride in any vehicle designated by the adult in whose care the minor has been entrusted while attending and participating in Chicago Bultasa Buddhist Temple  sponsored activities.

NAME______________________________________ AGE______BIRTHDATE____________

ADDRESS____________________________________________________________________

PHONE: HOME _______________ CELL _________________ WORK __________________

EMAIL: ___________________________________

Emergency Contact and Number___________________________________________________

Physician____________________   Physician’s Number______________________________

Participant Signature____________________________

Date:___________________

Father/Mother/Legal Guardian Signature­­­­­­­­­­­­­­­­_______________________ (circle the one that applies)

4360 W Montrose Avenue Chicago, IL 60641  Tel. 773) 286-1551, Fax 773) 282-2663, Email:bultasa@gmail.com               www.bultasa.org

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If you cannot download the forms or any problems, please contact me at 333m333@gmail.com