REGISTRATION FORM - BIG-HUMP 2006 Campout / Float Trip - Aug. 25th, 26th and 27th

Hash name________________________________

Nerd name ________________________________

Kennel ___________________________________

Address___________________________________

City ______________________________________

State _________________Zip_________________

E-mail ____________________________________

Phone ____________________________________

Post your e-mail to the Who's Coming page?_____

Vegetarian?_________ Carnivore? _____________


If you pay after Aug 1st:

_________ ($80.00) I want it all! (Camping, Floating, Hashing & Give-aways)

_________ ($60.00) No Float Trip (Camping, Hashing & Give-aways only)

_________ ($35.00) Float Trip & dinner afterward only (no camping or hashing no Give-aways)

_________ ($70.00) No Give-aways (Camping, Hashing & Floating only)


CUSTOMARY DISCLAIMER

I hereby release the Hash House Harriers from responsibility for any injuries, deaths, debts, pregnancies or any other misfortune which may befall me related to my participation in this event. In other words, if I get hurt, it's my own stupid fault.

SIGNATURE:_____________________________ DATE: ____________________


Make checks payable to Big-Hump

Please print, sign and mail to Frozen C. Shot at:

Joe Neyer
617 N. Ballas Rd.
Kirkwood, MO 63122