12/04/2009 Through 05/21/2011
$ 69 Until 11/29/2009, $ 80 Until 12/04/2009, $ 80 Until the Day of.
Please Make Checks Payable to Carolina Trash and Mail this completed form and your payment to:
LaNae Klann
HashCash@CarolinaTrash.com
5806 Bacarro Place
Fayetteville, NC 28314
Hash Name:____________________ Home Hash (No Abbreviations):______________________
First Name:___________________ Last Name:___________________
Street Address:________________________________________________________
City:_________________________________ State:_____ Zip Code:______________
Phone1:_________________ Phone2:_________________ Email:________________________
Shirt Size:( Small ) ( Medium ) ( Large ) ( X-Large ) ( XX-Large )
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 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.
Signature:_____________________________ Date:____________
To Pay or Register online, visit the following address!
www.hashspace.com/events/flash-mob-hhh-number-two