All guests and event participants at Atisha Centre are required to complete this form one time (unless the circumstances below change).
Your first name:
Your last name:
Your address:
Your telephone no.:
Your email:
EMERGENCY CONTACT DETAILS
Contact's name:
Relationship to you:
Contact's telephone:
In the interests of your safety and our duty of care, please indicate any illnesses or medical conditions of which we need to be aware or write "None":
As a visitor to Atisha Centre, I agree to abide by the five Buddhist precepts:
1. No killing any living being; 2. No stealing; 3. No lying; 4. No sexual misconduct;
5. No intoxicants (including tobacco, alcohol or drugs).
I accept that in the event of an emergency Atisha Centre may need to call an ambulance.
I accept that I shall be liable for any expenses incurred.
Thank you for completing these details.
By clicking the "Submit" button, you agree to the above conditions.