Request edit access
Yuan Shi Dian New Normal Promotion and Services Reservation Form 原始点新常态推广体验服务预约报名表   02-06-2024 (09:30am)                                                                         
Email *
免责声明书协议：通过这份同意书，我本人认识和理解，中心志工非医疗专业人士，而且不能诊断疾病或任何不适，亦不会提供任何医疗处理方法、药品、开立处方或借以贩售原始点辅助用品。所有原始点学习者亦应秉持中心公益原则，拒绝所有消费原始点的商业行为。我充分认识到按推的潜在风险，在练习示范中用于我身上的按推，完全是为了推广教育的目的。我明白我得到的按推或其他说明，不能取代医疗处置。我为我的健康和现有的或潜在的健康问题承担所有风险，拋弃对中心志工及学员在练习中的刑、民责任。 DISCLAIMER :  Through this consent form, I understand and aware that the volunteers of the Organisation are not health care professionals and cannot diagnose any diseases, illnesses or discomfort and do not provide any medical treatment and medicine. I am fully aware of the potential risk of Antui. The Antui applied on me during practical or demonstration is for the purpose of promotion and education. I understand that Antui and other forms of material / methods provided to me are not a substitute for medical treatment.  I shall assume all risks for my health either present or potential, and will not hold the Organisation and its volunteers responsible and liable for all matters arising thereof. *
Required
是否曾经到中心来参与推广体验服务 (Attended before? Y/N) * *
体验者出生日期  D.O.B of the Participant (E) 
(DD/MM/YY) * (10/10/1988)
 *
同意条款：1）本人同意并了解主办单位，Pertubuhan C.C.H. Yuan Shi Dian Malaysia (C.C.H. Yuan Shi Dian Malaysia Organisation) (“中心”) 是基於活动办理之相关行政作业及推广原始点的目的，收集并使用本人之个人资料(包含中英文姓名、身份证号码、电话号码、电子信箱等资料)。本人同意中心向本人收集活动需求所需之所有资料以供活动及原始点推广用途。2）若成功报名，本人同意中心将本人之姓名公告在官网的录取名单之中。 3）为落实个人资料之保护，依照个人资料保护法(Personal Data Protection Act 2010) 第7条规定进行蒐集前之告知：一、蒐集之个人资料类别： i)中文姓名 ii) 身份证英文姓名 iii) 身份证号码 iv) 联络电话 v) 电子邮件信箱（Email）vi) 主办单位因活动需求所需收集之资料，由主办单位另定之。二、个人资料蒐集之目的及用途：目的在於进行活动办理之相关行政作业，主办单位將利用您所提供之Email及联络电话通知您活动之相关讯息。三、个人资料利用之期间、地区、对象： i) 期间：您同意报名之时，由主办单位保存您的个人资料，以作为本人、主办单位查询、确认证明之用。 ii) 地区：您的个人资料将用於活动主办单位提供服务之地区。 iii) 对象：透过网路报名系统之使用者。四、报名者对个人资料於保存期限內得行使以下权利： i) 查询或请求阅览。ii) 请求制给复制本。 iii) 请求補充或更正。 iv) 请求停止蒐集、处理或利用。 v) 请求刪除。五、提醒：您可自由选择提供个人资料，若其提供之资料不足或有誤时，将可能导致无法成功报名活动。请問您是否愿意以电子文件方式同意主办单位蒐集、处理及利用您的个人资料： (请注意，此处点选同意具有个人资料保护法（Personal Data Protection Act 2010）所定之书面同意效果。) 同意，代表您已阅毕个资告知事项，並愿意以电子文件方式同意主办单位蒐集、处理及利用您的个人资料。不同意，代表您不同意主办单位於每次活动蒐集、处理及利用您的个人资料，请关闭此页面，此次报名将不会成功。若有任何疑問您可点洽主办单位的服务专线 (012-988 7876) 或 Email (ysdmalaysia@gmail.com) 。   TERMS OF AGREEMENT AND CONSENT:  1) I agree and understand that Pertubuhan C.C.H. Yuan Shi Dian Malaysia (C.C.H. Yuan Shi Dian Malaysia Organisation) (“the Organisation”) is collecting, compiling and using my personal data (including name, phone number, e-mail and other personal information) for administrative purposes of the activities conducted. I hereby expressly agree for the Organisation to use my personal information for the purpose of Yuan Shi Dian promotion and activities of any nature whatsoever.  2) If my application / registration is successful, I hereby grant my consent for the Organisation to announce and state my name in the participants list in the official website of the Organisation.  3) In compliance with Section 7 of the Personal Data Protection Act 2010, notice is hereby given to you being the data subject that : 3.1. The description of the personal data being processed is as follows :- (i) Name as per the Identity Card (ii) Identity Card number (iii) contact number (iv) Email (v) the data and information required by the Organisation as shall be prescribed by the Organisation; 3.2. The purposes for which the personal data is being used or collected and further processed are for administrative purposes and the Organisation will utilise the contact number and email provided by you to notify you in respect of the information of the activities involved; 3.3.  The time of collection and the class of third parties to whom the Organisation discloses or may disclose the personal data are as follows: - (i) The time of collection: The Organisation will collect your personal data at the time when you submit your registration for the purposes of verification and identification (ii) The class of third parties to whom the Organisation discloses or may disclose your personal data: The visitors of the Organisation's official website.  4. You have the rights to request access to and request correction of your personal data by giving written notification to the Organisation. You may also contact the Organisation with any inquiries or complaints in respect of the personal data through email (ysdmalaysia@gmail.com).  5. It is obligatory for you to provide your personal data.  If the personal data provided by you is insufficient, inaccurate or misleading, it will lead to unsuccessful registration of the classes / programmes conducted by the Organisation.  Do you agree to allow the Organisation to collect, disclose and use your personal data? (Please take note that if you select “I agree”, this is amounting to your written consent as required under the Personal Data Protection Act 2010). It further means that you have read the Notice and Choice Principle under the Personal Data Protection Act 2010) and agree to allow the Organisation to collect, disclose and use your personal data.  If you disagree, please close this page and your registration will not be successful.  Should you have any queries, please contact the Organisation through hotline (012-988 7876) or email ( ysdmalaysia@gmail.com). *
Required
活动规范及注意事项：1) 请携带身分证、穿棉质衣裤，大小毛巾各2件。2) 学员及陪同家属 : 每一位学员只能由1位家属陪同。3) 报到时间如下:- 星期日: 09:30。4) 若参与者没有准时在上述的报到时间抵达中心, 中心将保留取消参与者名额的绝对权力。5) 学员需扫描中心提供的二维码以登记签到。6) 如何确认是否已成功报名 : 请登入官网按照您预约的日期来查阅“体验服务预约录取名单”。成功录取与否将以 “体验服务预约录取名单” 为准。 7）中心之权利：i) 中心保留绝对权利更改、调整、取消活动现场安排及与此课程相关的一切事宜。ii) 若遇自然灾害或任何不可抗力因素，中心将保留举办与否之绝对权利。Terms & conditions of activities and points to be noted:-1) Kindly wear soft cotton knitted top & bottom and bring along your Identity Card and 2 pieces each of the large and small towel. 2) Each participant can only be accompanied by one (1) family member. 3) Reporting Time: The reporting time for the participants and their accompanied family members is as follows:-Sunday Session : 0930.   5) Everyone is required to scan our Organisation's QR Code as well for registration purposes before entering our premises.  6. The way to confirm whether your reservation is successful : Please log on to our official website to check the "Promotion and Services Participants List" according to the reservation date that you have selected.  The acceptance of the reservation shall be based on "the Promotion and Services Participants List".  7.  The rights of our Organisation: (i) Our Organisation reserves the absolute rights to alter, adjust and cancel any activities, classes, arrangements and all other related matters. (ii) In case of natural disaster or any unforeseen circumstances, our Organisation will reserve the absolute rights to decide whether or not to proceed with the activities. *
Required
手机 （Contact No.: 012-1234567） *
体验者姓名 (Chinese Name of the Participant)
体验者身份证英文姓名 (English Name of the Participant as per I.C. ) *
备注   Remarks:
※ 为统一作业，活动现场不接受报名。
※ 请勿重复报名。
※ 陪同家属不需要报名预约。

No on-site registration is allowed.
Avoid duplicating application.
The family member is not required to make online reservation.
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms