Ajahn Brahm’s Hong Kong Teaching Tour 2018

Highway to Happiness
Day of Mindfulness at Centre on Behavioral Health, HKU
27 February, 2018 (Tuesday) 10:00 am – 4:00 pm
2/F., 5 Sasson Road, Pokfulam, Hong Kong.

Registration Form
Please read the details before completing this application form. (*Compulsory to fill in)
Full Name in Block Letter* Full Name in Chinese (if applicable)

Gender* Male / Female Occupation*

Mobile/Telephone No.* Email Address*

Residential Address:

Emergency Contact*
Person Name and Telephone No.
What motivates you to join
this event & what is your expectation?

Do you wish to receive future information from the organizer?* Yes / No

Declarations:

I, _________________the undersigned hereby declare that the above information is true. I am also willing to
abide by the organizer/meditation instructor’s advice and the rules and regulations of the workshop.
Otherwise, I will have to leave the workshop as instructed by the organizer/ meditation instructor. I hereby
agree and accept that neither the organizer nor the management of Bodhinyana Foundation Limited shall be
held liable in the event of any injury (mental or physical), losses or damages occurred during this workshop.

Signature: ______________________________ Date:__________________________

Registration Method:
Please return the completed Registration Form along with the cheque by mail or in person to the address
below. Please make cheque payable to “The University of Hong Kong”.

Centre on Behavioral Health

The University of Hong Kong
2/F., 5 Sassoon Road, Pokfulam, Hong Kong.

Fee: HK$250.00** (Including vegetarian lunch and tea)

Enquiry - Tel: 2831 5158 Fax: 2816 6710

** (Fee paid is not refundable)