Hash Affiliation (No Abbreviations except H3, H4!)
Price Options:
Registration Fee:
Early, Received Before January 30 th. - - - - $40.00
Late, Rec'd ON or After January 31 st. - - - - $50.00
Special Half-Ass rate for silly excuses - - - - $25.00
NOTE: ONLY a T-Shirt IS included with the Half-Ass rate. No other goodies!
Some valid Half-Ass excuses: (we reserve the right to DENY excuses we deem insufficient)
* I can only make one day! (can be used any ONE day)
* I don't drink Beer! (good any number of days)
* I don't want the goodies! (good ONE day only!) (you may reject the T-Shirt)
* I don't want to hang out with you guys, I just want your GREAT hotel rate! This will be ENFORCED!
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!
*Registration Fee
My Half-Ass Excuse
NOTE: You need YOUR OWN PayPal account to use PayPal.
*I want to pay via PayPal - $1.00 extra
Total Due
Comments (optional)
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
Entering your name in the signature block indicates your acceptance of these conditions.
*Signature
*Date
After you click "Register", this form will be displayed
again.
If you are paying with PayPal, no need to mail your form. Just click the "Pay On-Line by PayPal" button and finish there!
Otherwise:
You must Print the form, 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
