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  Nash Hash Registration Form
(Click here to download the form)

INDIAN NASH HASH 2005

Please complete in BLOCK LETTERS.

Family Surname:            ____________________________Nationality:                      ______

Given Names:                                             Sex: M/F     _Hash Name:                     ______

Partners Surname:                                     Sex: M/F      _Nationality:                     _______

Partners Given Name:                           _______________Hash Name:                      ______

Horror 1:                                                       Hash Name :                  __ Age :            Sex: M/F

Horror 2:                                                      Hash Name :                   ___Age :            Sex: M/F

Postal Address:                                                                                                                        

                                                                                                           

Telephone      Home:                                                                     Work : __________________

Fax:                                                                       Cell:         ________________

E-Mail Address:                                                                                                                      

Home Hash:                                                                                                                        

Possible Medical Risks (heart/diabetes/asthma etc):   __________________________________

Name, Address & Contact number of person to contact in
event of any Emergency :_______________________________________________________
                                     ________________________________________________________

Transport Bangalore to Mysore and back :   Needed / Not needed ( tick whichever is applicable)

Arrival details in Bangalore: _______________________________________(Give flight / train details including date and time)   

Departure from Bangalore: _______________________________________(Give flight / train details including date and time)    

Hash Name

T Shirt size (S/M/L/XL/XXL)

Walk / Short Run / Long Run

Normal drink – Water / Beer / Soft Drink

Vegetarian / Non Vegetarian
         
         
         

                                   Signed:________________________

REGISTRATION FEE :

Up to 15/05/2005

Up to 15/06/2005

Up to 31/07/2005

INR 5000

Under 5 free; no goody bag for kids

Age 5-12 – INR 3500

INR 6 000

Under 5 free; no goody bag for kids

Age 5-12 – INR 4000

INR 7000

Under 5 free; no goody bag for kids

Age 5-12 – INR 5000

USD 125 / USD 88 for Horrors aged 5-12

USD 150 / USD 100 for Horrors aged 5-12

USD 150 / USD 125 for Horrors aged 5-12

All rates assume two or three persons per room – single room supplement will be INR ( Indian Rupees) 2000 per head or USD 50 per head.  Payments from India can be by Bank draft or cheques payable at par in Bangalore. ( Please add Rs 200/cheque for other outstation cheques). Registrations fees once paid are non-refundable, however you can sell your registration to another hasher as is the hashing norm. 

Please note that the registration fee includes accommodation at a 3 star hotel for Saturday 13/8/2005 and   Sunday 14/8/2005, all meals from breakfast on 13/8/2005 to lunch on 15/8/2005 runs, goody bag, transport to and from runs, shuttle bus as per the schedule of events etc.  Free transport will be provided ex Bangalore on 13th morning (ETD between 7 and 9 AM and return to Bangalore on 15th afternoon ( ETD Mysore between 1.30 and 3 PM). No discount for those making own travel arrangements for Bangalore-Mysore-Bangalore sector or those who wish to arrive or depart at different times.

Registration fees exclude all items of a personal nature, visas, any pre and post ambles and any optional tours unless otherwise specified in the itinerary.

Optionals Those arriving in Bangalore on 12th August can be accommodated in a centrally located hotel at Rs 2500 ( USD 63) per double room per night. You need to book this immediately as hotel rooms in Bangalore are very difficult to get. A pub crawl has been planned on 12th evening at a cost of Rs 500/head (or USD 13/head). IF YOU NEED ACCOMODATION AND/OR WISH TO PARTICIPATE IN PUB CRAWL, PLEASE PAY ALONG WITH REGISTRATION.

Number of double rooms needed in Bangalore :_______________________________________

Number of persons participating in Pub crawl :________________________________________
 

I enclose my: Cheque / Bank Draft  for INR / USD
Made payable to:  Bangalore Hash House Harriers                       

Mail the form and payment to :
Jagannath Raju(Nash Hash)
20, 1 A Cross, 17 A Main, J. P. Nagar Phase 2
Bangalore 560 078
Tel : 91-98450-65071 

 

DISCLAIMER :

I acknowledge that in consideration of my being accepted as a participant in Indian Nash Hash 2005, I hereby release all persons and bodies concerned with the organisation and conduct of Indian Nash Hash 2005 from any claims or actions whatsoever by me or my heirs, executors or assigns, arising from any injury by me or any loss or damage to property associated with my participation in Indian Nash Hash 2005.

Signature:                   __________________                      Date:  _________________   

Partners Signature:       __________________                     Date:  _________________

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

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For official use only:

Date received: ___________    Date entered: __________       Reg. No: ___________  

Remarks:   _______________