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| Hash Chapter | _________________________________ |
| Hash Name | _________________________________ |
| Family Name | _________________________________ |
| First Name | _________________________________ |
| Address | _________________________________________ |
| _________________________________________ | |
| _________________________________________ | |
| Home Phone | _________________________________________ |
| Work Phone | _________________________________________ |
| Fax | _________________________________________ |
| Cell Phone/Mobile/Handy | _________________________________________ |
| _________________________________________ |
T-Shirt Size M L XL XXL (Circle preferred size)
Accommodation Requirements (Circle preference) :- Crash Space (limited)/Book 2 star hotel/Make own arrangements
I declare that my participation in the 900th weekend organized by the
Vindobona Hash House Harriers is entirely at my own risk and responsibility
and I will not hold anyone liable for any loss, damage or injury which
I may sustain.
Date :__________________ Signature: ________________________________
Return this form to Fax number +43-1-2600-29104 or John Russell, IAEA, P.O. Box 200, Wagramerstrasse 5, A-1400 Vienna, Austria.
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