☸️ Texas Pagoda Chan Monastery Visitors Registration Form 德州寶塔禪寺訪客登記表
     Please fill out the following form to register to visit Texas Pagoda Chan Monastery. If you would like to bring friends, please ask them to register as well. Once you submit the form, WE WILL REVIEW AND CONTACT YOU WITH A CONFIRMATION BY EMAIL.

     Please review these COVID-related restrictions. We would ask you to delay your visit if any of the following are false.

1. I have not recently experienced any of the following symptoms: fever of 100.4F or greater, cough, sore throat, shortness of breath or difficulty breathing, chills, muscle aches, headache (not attributed to a chronic condition such as a migraine), new loss of taste or change in taste or smell, or other symptoms of illness.
我最近沒有以下症狀: 發燒超過華氏100.4度,咳嗽,喉嚨痛,氣短或呼吸困難,發冷,肌肉酸痛,頭痛(非慢性疾病所引起的頭痛如偏頭痛),最近剛發生味覺的喪失或有味覺、嗅覺的改變。其他感冒症狀。

2. I have not been in close contact with anyone who has been confirmed positive for COVID-19 within the past 7 days.

3. I have not been confirmed positive for COVID-19 in the past 14 days.

4. I agree to the Pagoda Chan Monastery's requirements, including: wearing masks, social distancing. I also agree that I voluntarily assume the risk that I may be exposed to or infected by COVID-19 in the Pagoda Chan Monastery and I waive any liability against the Pagoda Chan Monastery and any other parties.

Thank you for your cooperation! 感謝您的配合! 🙏🏻
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By agreeing, you affirm that the above statements are true. 點選「我同意」代表我確認以上的陳述都是真實無誤的。 *
Name 姓名 *
Email 電子郵件信箱 *
Phone Number 電話號碼 *
The date you would like to visit 您想參訪的日期 *
The time you would like to visit 您想參訪的時段 *
Currently open from 2pm to 5pm! 目前開放的時間為下午兩點到下午五點!
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