REGISTRATION FORM

Africa Hash 2013!

7-9 June 2013     www.accrahash.com

Name:                 ­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­__________________________________________________________    

Hash Handle:                                                                                                                                                              Sex: M / F / O  

Home Hash:                                                                                                                                                             

Address:                                                                                                                                                                                                            

Phone:                                                                                                                       Email:                                                                             

Nationality:                                                       Date of birth:                           Passport No:                                                               

T-shirt size (circle one):       Small       Medium       Large       XL       XXL       Fat Bastard

I relinquish all right of redress of the culpability of Africa Hash 2013 for any outrages I may perpetrate on myself.

Signed:                                                                                                                                         Date:                                                                                                  

Cost: $150 to 31 Dec 2011, $200 to 31 Dec 2012, $250 thereafter

All registrations are fully transferable WITHOUT A TRANSFER FEE.

Note that both a completed form and receipt of full payment of the registration fee is required for registration. Please complete and email to cathydan@yahoo.com OR post to

Africa Hash 2013, PO Box 1542, Accra, Ghana

Payment by credit card has proved impossible in Ghana, so you’ll have to wire your money to the following account:

Account name: Accra Hash House Harriers
Account number:  0401014425751401
Bank name and address: Ecobank, Madina, Accra, Ghana
Swift Code: ECOCGHAC

For Mismanagement use only:

Date received:                                                                 Registration Number:                                                                        Processed by: