REGISTRATION FORM - BIG-HUMP 2006 GREENDRESS RUN - 3/18/06

The one day registration price will increase to $35.00 on Thursday March 16th. Register soon!

Hash name________________________________

Nerd name ________________________________

Resident Hash______________________________

Address___________________________________

City ______________________________________

State _________________Zip_________________

E-mail ____________________________________

Phone ____________________________________


_________ I want it all! ($75.00) What a deal!!!


_________ I am cheap. ($30.00) Saturday's run and the on-after only. (NO GIVEAWAYS)
                                  

Jacket size?

_____ Med _____ Large_____ XL _____ XXL

Vegetarian?

_____ Yes _____ NO

Do you want us to put your e-mail address on the Who's Coming web page?

_____ Yes _____ NO


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 Sandy Thomas

Please print, sign and mail to Pornogenic at:

Sandy Thomas
7451 Warner
St. Louis, MO 63109