OPEN AWARENESS MEDITATION RETREAT
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Name
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Age
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NRIC
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Home address
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email address
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Handphone No/home No:
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Next of kin to be contacted in case of emergency:
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Relationship
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Contact No
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Address
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Meditation experience: Yes / No
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Meditation experience:
History of mental abnormality
Other physical health problems: Yes / No
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If yes, please state nature of problem
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I hereby declare that the above information is true and I am willing to abide by the meditation instructors' advice. Otherwise, I will leave by my own accord. I also understand that the organizers and the meditation instructors shall not be held responsible for any physical or mental injury incurred during or after attending this retreat.
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