Complete this form and mail it along with a US *check/MO in the amount of $99.00 to:
USA Nash Hash, c/o Doc Savage, 10800 Canyon Place, Rapid City SD 57702 USA
*Make check or money order payable to "USA NASH Hash 2008"

Mortal Name:
Hash Name:
Current Home Hash:
Tel number:
Email Address:
Mailing Address:
City, State, Zip:	Postal Code/Country if not U.S.:
Circle T-shirt Size:	M   L   XL   XXL
I understand that Hash House Harriers activities are very demanding and sometimes dangerous. I attest that I am in good physical condition and am not under a physician's care. I realize that there are alcoholic beverages available and I am under no requirement to drink them. If I do drink, it will be because I am 21 years of age or older and I will not over-drink, injure my health, or drive while intoxicated. I have a right to get hurt if I want to and if I do, it is my bloody fault and I will not blame the USA Nash Hash mismanagement, associated Hash House Harriers groups, or their heirs.
Signed: