Interhash 2016 Registration Form

Name
Hash Name
Hash Club
Passport / ID Card / KTP
Nationality
Date of birth	12345678910111213141516171819202122232425262728293031 JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember 1995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920
Gender	Male Female
GM	YES NO
Contact
Email
Mailing Address
Country
Home Phone
Hand Phone
Emergency Contact
Name
Phone
Detail
Tshirt	XS S  M  L  XL  2XL
Food	Halal  Vegetarian  Eats Anything
Preferred Run
Saturday	Short Medium Long Ball Breaker Not Running
Sunday	Short Medium Long Old Fart Not Running
Confirmation Code
I accept that the Organising Committee of the Interhash 2016, the Hare(s) duly appointed by the committee, sponsors and the owners of the land and property where the runs may take place will take reasonable measures to ensure safety and well being of the participant but accept no liability for any injury, damage or loss, however these may occur. I will not hold the committee, its members or any affiliated person(s) responsible for any accident, loss, damages or injury sustained by me before, during or after the event. I accept that all Registration Fees that I pay are non refundable if I am unable to join the Interhash 2016 event. I accept that Run Fees are calculated from receipt date of full payment at Interhash 2016. (All bank charges to be borne by individual hashers. Remember, you have paid us what we receive, not what you give the bank!). I agree with terms & conditions above

1. We do not accept group registration. All participants must register by themselves
2. Please be careful about your T-Shirt size. You cannot change it later

01 Jan 2014. 16:04