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[3 June - 29 August 2019] 3 Months Zen Retreat
Date | 日期: 3 June - 29 August 2019

Venue | 地点: Desaru Zen Meditation Centre | 迪沙鲁禅修中心
Address | 地址: No. 13, Jalan Belian 5, Marinea 2, Taman Desaru Utama, 81930 Bandar Penawar, Johor, Malaysia.

Fee | 收费:S$600 (不包括交通费用 not inclusive of transportation)

Payment | 付款: Please visit our centre to make payment as we only accept cash payment for this event. | 由于此项目只接受现金,请到观音禅林付款。

Personal Particulars 个人资料
English name 英文姓名 (as shown in NRIC/passport) *
Your answer
Chinese name 中文姓名
Your answer
Gender 性别 *
Handphone / Residential no. 电话号码 *
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Email 电邮
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Age 年龄 *
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Nationality 国籍 *
Passport Number 护照号码 *
Your answer
Language / 语言 *
Occupation 职业
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Food Allergy 食物敏感
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Health Status 健康状况
Any history of asthma? 是否有哮喘的历史? *
Any history of mental illness? 是否有精神疾病方面的历史? *
Others 其它
Length of stay (DD-MM-YY to DD-MM-YY) 入住与离开日期 *
Your answer
Have you participated in any retreats organized by Kwan Yin Chan Lin Zen Meditation Centre? 您是否有参与过观音禅林举办的禅修活动? *
I would like the organiser to arrange transport for me. 我希望主办方替我安排交通。 *
How did you get to know about this activity? 您是怎么获知这项活动? *
Emergency Contact 紧急联络
Name 姓名 *
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Relationship 关系 *
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Address 地址
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Contact No. 联系号码 *
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Declaration 声明
I hereby declare that the above information is true and am willing to abide by the Organizer's advice and the Zen Centre's regulations. I also understand that the Organizer will not be responsible for any injury incurred during the activity, and also agree to the usage of photos taken during the activity by the organizer. I also agree to receive email from the organizer. 谨此表示以上所填写內容属实, 我愿意遵守观音禅林的规定及负责人的指示。我同意在活动期间若出现任何意外, 观音禅林将无需承担任何责任。我也同意主办单位用当天所拍到的照片。我也同意主办单位发送电子邮件给我 。 *
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