JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
2 Days Eight Precepts Retreat八關齋戒
1.請務必依照報到時間 7月28日下午5:00pm~6:00pm辦理報到,若無法準時報到者,請事先告訴本寺,以利作業。
2.填完資料,必需要按最下面的【提交】鍵,才算完成報名。
3.一次請填寫一個人的資料,如有第二人要參加,請填完並按最下面的【提交】鍵後,再填第二次。
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Name:
*
Your answer
中文姓名 Chinese Name:
Your answer
性別 Gender:
*
男 Male
女 Female
語 言 Language :
*
普通話 Mandarin
廣東話 Cantonese
Required
年齡 Age:
*
Your answer
地址 Address:
*
Your answer
電話 Phone:家 Home:
*
Your answer
手機 Cellular Phone:
*
Your answer
電子信箱 Email:
Your answer
身高 Height:
*
Your answer
體重 Weight:
*
Your answer
學歷 Education:
Your answer
職業 Occupation:
Your answer
是否會打呼 Do you snore
No
Yes
Clear selection
居士服 Lay Devotees Outfit:
*
自備 Own
現場購買 Will Purchase
皈依師長、皈依地點、皈依時間 Refugee teacher, place, and date:
*
Your answer
如何得知此活動的資訊 How do you know this event:
來莊嚴寺看到 Poster in the monastery
朋友介紹 Friends
網站上 Website
美佛慧訊 Wisdom Journal
Other:
※您有沒有健康方面的問題?Do you have any health concern?
*
如糖尿病、高血壓、癲癇症、腸胃炎…等, 或傳染性疾病:肝炎、肺結核、傷寒…等,或運動性傷害:開刀、骨折…等
無 No
Other:
您現在或過去有沒有精神(心理)方面的問題?Have you ever suffered from or have been diagnosed with mental health issues?
*
無 No
Other:
您對任何藥物或食物過敏?Food Allergy?
*
無 No
Other:
請提供其它需注意事項 Other Information:
*
(身體有特別狀況不適宜義務勞動者,請告知)
Your answer
為方便學員上山,只於報到日及圓滿日提供交通車接送 Transportation。
*
我要搭乘Metro North Grand Central 03:18pm to Cold Spring 4:31pm (我們只提供7月28日4:31PM Cold Spring火車站到莊嚴寺的交通接送。)可自費搭乘一帆旅遊巴士公司交通車至莊嚴寺(請直撥718-888-1016報名登記) 或私人車行646-246-1898(Amy)
不要 No
要 Yes
緊急連絡人姓名(中文、英文、關係)Emergency contact (Name, Relationship)
*
Your answer
緊急連絡人電話(白天、晚上、手機)Emergency Contact's phone (Day, Evening, Cell)
*
Your answer
參加者聲明:我對以上表格回答屬實,並於活動期間,遵守佛陀之戒律、寺院之規範;且如有病痛、金錢、物質之損失、任何意外事件而受到傷害,概由參加者自行負責,美國佛教會及莊嚴寺不負任何法律責任、賠償責任。Waiver of Liability: It is fully understood that the BAUS and/or Chuang Yen Monastery cannot be responsible for illness or injury suffered during the retreat. I am fully responsible for the damage or loss of my personal belongings.
*
我已閱讀、了解並接受之
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Buddhist Association of the United States.
Report Abuse
Forms