Please provide name and contact information.

Please list all days you want to attend and time if applicable.

I attest that the information given in this application form is true and correct. I understand that the centre reserves the right to reject my application and/or ask me to leave should the information, in whole or in part, prove to be materially untrue and incorrect.

Furthermore, I shall not hold PSMC or the sangha responsible and/or liable for any mishap, untoward occurrence, physical mental illness that may occur before, during and/or after my retreat.

I undertake to abide strictly by the rules of this centre, to practice sincerely and conscientiously, and to follow closely the instructions of the meditation teacher.

I will not hold the centre liable and/or responsible for and items lost in its premises.