2023 Wesak Day Retreat Registration Form 
DATE: WED 03/05/2023  – THU 04/05/2023
Check in: Wed 03/05/2023 7:30pm
Check out: Thu 04/05/2023 5:00pm

REGISTRATION CLOSING DATE : 02/05/2023 

Max # participants: 30

CONTACT: Bro. Robin (WhatsApp: +6016 442 2336)

RETREAT INFORMATION: This retreat is suitable for beginners as well as more experienced students.

RETREAT FORMAT: The medium is in English and Mandarin.

NOTES: 

  1. By joining this class:
    • You agree to abide by the 8 precepts and observe AVMC rules/regulations during the retreat.
    • After your registration is accepted, You agree to be contactable via WhatsApp group chat. This is because our primary communication will be done through this channel.
    • You give your consent to the storage and use of the submitted information by the organizers for internal organisational purposes only. Your personal data will not be shared with third parties
  2. First preference for acceptance will be given to those participants who can attend the full retreat.
  3. The course is offered free of charge. If you'd like to make a donation, please see details on https://www.sayalaysusila.net/donation
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Email *
I have carefully read and understood the above course descriptions and agree with the requests.  *
Last Name  (FAMILY name)
 *
Kindly CAPITALIZE your surname / last name/ family name
First Name 
 *
Age Group *
Gender 
 *
Mobile Number
 *
Kindly install WhatsApp if you don't have it and provide mobile number that is associated with your WhatsApp account (with "+", Country & Area code). 
Nationality
 *
Country of Residence 
 *
State/Province 
 *
Please choose the group that best describes you 
 *
Please list any medical conditions. For example, high blood pressure, diabetes, kidney or heart problems, asthma, or psychological diagnoses. *
Do you take prescription medications? If so, Please specify medications. *
Please list an emergency contact person: Full name, relationship, phone number (with country code if outside Malaysia) *
Please indicate if you would like to contribute to Breakfast or Lunch dana, or maintenance (can be paid on day of registration)
 *
yes
no
Breakfast (RM 300)
Lunch (RM 400)
Maintenance (any amount)
Please give your arrival/departure and transportation details. Please be as specific as possible: e.g. will you be arriving by car, airplane, taxi/Grab? Will you need to arrive a day early or stay after the retreat closes? *
A copy of your responses will be emailed to the address you provided.
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