Seletar Hash House Harriers
1000th Run Celebration
25-27 September 1998

Registration Form

 
Name: _________________________________________________ Sex:  M  /  F
 
Address: ______________________________________________________________

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Country: ______________________________________________________________
 
Phone: ________________ Fax: ________________ E-mail: _________________
 
Nationality: ________ Passport No: __________ Date of Birth: __________
 
Home Hash: ________________________ Hash Name: ________________________
 
Does your Hash wish to contribute an act for the entertainment? Yes / No
 
Please circle preferred T-shirt size:  36"  38"  40"  42"  44"  46"  48" 
 
Please circle preferred run length:
Short (50 minutes), Medium (1 hour 15 minutes), Long (1 hour 40 minutes)
 
Please circle (one or more) type(s) of food that you would like:
     Chinese     Indian     Malay    Western
 
I enclose my Personal Cheque / Bank Draft / International Money Order
made payable to "Seletar Hash House Harriers"
 
No. _______________ for US$_________________ Dated___________________

I understand that my consent to these provisions is given in consideration for being permitted to participate in this event. I am aware of, and voluntarily assume the risks of, coming to this event. If I am injured, I agree that I will not sue, or otherwise hold responsible, the Seletar Hash House Harriers, or any affiliated individuals, or any run sponsor and/or their employees.

Signature_______________________       	Date______________

(Please note that this form is not valid without a signature and a date, and full payment of registration fees)

For official use only:

Date received___________ Date entered___________ Reg. No:____________
Remarks: _______________________________________________________________
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