Zen Center Visitors Registration Form 精舍訪客登記表
Please fill out the following form to register to visit Chung Tai Zen Center of Houston. 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.
2. I have not been in close contact with anyone who has been confirmed positive for COVID-19 within the past 14 days.
3. I have not been in close contact with anyone who is experiencing symptoms of COVID-19 but is not yet to be confirmed within the past 14 days.
4. I have not been instructed by a health care provider or public health authority to be under home quarantine within the past 14 days.
5. I have not been confirmed positive for COVID-19 in the past 14 days.
6. I have not traveled outside the country or on an airplane within the past 14 days.
7. I agree to the Zen Center's requirements, including: wearing masks, social distancing, taking of temperature, filling out questionnaire and consent form. I also agree that I voluntarily assume the risk that I may be exposed to or infected by COVID-19 in the Zen Center and I waive any liability against the Zen Center and any other parties.