REGISTRATION FORM - BIG-HUMP 2009 GREENDRESS RUN - 3/14/09


Hash name________________________________

Nerd name ________________________________

Resident Hash______________________________

Address___________________________________

City ______________________________________

State _________________Zip_________________

E-mail ____________________________________

Phone ____________________________________

_________ I want it all! ($84.00) What a deal!!!

_________ Friday night Social only ($25.00) (NO GIVEAWAYS)

_________ Saturday & Sunday only ($60.00) (no discounts for attending only one of the two days).

Shirt size? _____ Med _____ Large_____ XL _____ XXL

Vegetarian? _____ Yes _____ NO

Do you want your hash name & e-mail 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 Big Hump and send to:
P.J. Koch
7441 Grant Village Dr. #402
St. Louis, MO 63123