OPEN AWARENESS MEDITATION RETREAT
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Name
Age
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NRIC
Home address
email address
Handphone No/home No:
Next of kin to be contacted in case of emergency:
Relationship                                
Contact No
Address
Meditation experience:  Yes / No
Meditation experience:  
History of mental abnormality
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Other physical health problems:   Yes / No
If yes, please state nature of problem
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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