Nash Hash 2010 Rego
We're glad you want to cum to
Nash Hash 2010: The Madtown Experience
Hasher Info
*
Hash Name
*
Home Hash
*
Nerd Name (First)
*
Nerd Name (Last)
*
Sex:
Male
Female
Yes
*
Birth Month/Year (MM/YY)
*
T-Shirt Size
Small
Medium
Large
XLarge
2XLarge
3XLarge
*
Waist(ed) Size
Small
Medium
Large
XLarge
Beer Belly
Tent
*
Street Address
Address Line 2
*
City
*
State/Province/Region
*
Zip/Postal Code
*
Phone Number
*
Country
*
Email Address
The Nash Hash directory will be
emailed
(not printed) to all registered Hashers. The directory will include Hash Name, Home Hash, Nerd Name, Email Address, and Phone Number, unless you request otherwise.
*
Please DON'T list my _____________ on the directory. (Please select at least one.)
Nerd Name
Email Address
Phone Number
Who would want to contact me anyway -- just list it all!
What kind of trail do you prefer?
Eagle
Turkey
Fatboy
I am interested in participating in a Ballbuster trail.
*
What is your food preference?
Where's the beef?
Chicken & See Food
Vegetarian (I am a Sensitive soul)
Yes
Transportation / Lodging
For those arriving into Madison airport, please provide your flight details.
If not known at this time, you may email
nash2010@madisonh3.com
at a later date.
I intend to be a camper.
Emergency Contact Info
*
Emergency Contact Name
*
Emergency Contact Phone
Waiver
*
I will sign a liability waiver before participating in any Nash Hash 2010 activities.
Payment
Paypal only.
There will be an additional charge of $3.50 for Paypal.
You will not be considered registered until payment is processed.
*
Rego Payment - $89.69
This sale price good ONLY through September 1, 2008
One Nash Hash Rego + Paypal Fees ($3.50)
*
Indicates Response Required
Build forms with
FormSite.com