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| Name and Address: |
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| *Hash Name |
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Hash Affiliation
(No Abbreviations
except H3, H4!) |
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| Other Information: |
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THIS IS A RELEASE AND INDEMNITY AGREEMENT
Hashing may be a dangerous activity
involving walking or running over various types of terrain in
unpredictable weather. I accept the risks involved, some known and some
unknown to me at this time. I waive all rights for legal and/or civil
action against all person(s) participating in or organizing this event.
I forfeit all rights to sue anyone associated with or connected to the
participants in this event. I further attest that I am of legal drinking
age and will consume no more alcoholic beverages than I can handle and
will stop myself when I have consumed my personal limit. I am
responsible if I break any laws or hurt anyone due to my behavior. If I
disrupt the other hotel guests or take off my clothes, I know that I
will be kicked out of the hotel and possibly carted off to jail --
that's totally my fault too
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Registration Fee: received By Jan 31 st $40, received After Jan 31 st $50
One Day Only Registration Fee: Same as Above
For those who do not drink beer: Same as Above
Extra goodies and T-Shirt ONLY GUARANTEED with EARLY
registration! The Late Fee is assessed by the date we
get your check, NOT the date you register On-Line! |
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After you click "Register", this form will be displayed
again. You must Print it, Sign it, and snail mail it along with
your check, payable to "Richard Uschold" to the address
below.
Richard Uschold
80 Woodview Dr.
Port Orange, FL 32129 |
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