PGH3

12th PHILIPPINES NASH HASH
Puerto Galera  May 12th – 15th  2011

ONLINE REGISTRATION FORM

  
  • Please complete one form per participant
  • Please fill in all fields - the form will not process if any fields are blank. If any field does not apply type 'n/a' or 'none'
  • Read the disclaimer and check the disclaimer box. The form will not process if the disclaimer box is left unchecked
Family Name:
First Name:
Hash Name:
Hash Club:
Email Address:
Country:
  
T-Shirt Size:

Preferred Run Length:

NASH HASH FEES:

  • 3,000 Philippine Pesos until January 14th, 2011
  • 3,500 Philippine Pesos from January 15th, 2011
  • The first 50 participants to register pay only 2,500 pesos – check the website to see if you are still eligible!

PAYMENT OF FEES:

  • To Hash Cash (Deborah Barber) in Philippine Pesos cash
  • Send in Philippine Pesos via Western Union to "Gregory Brian Larkins / Puerto Galera, Philippines"
  • Send in Philippine Pesos to this bank account:

          Bank Name: Allied Banking Corporation
          Branch: Puerto Galera
          Account Name: Bruce Driver (PGHHH)
          Account Number: 866-0-02014-7
          Swift Code: ABCMPHMM
          Routing: 113391

  • Australian participants can deposit into an Australian bank account, email hashcash@pghhh.com for details
  • If you are remitting fees, after you submit the payment, scan the receipt and send it to hashcash@pghhh.com for us to confirm your payment. Include your full name, hash name, hash club and nationality in the email.
  • If you absolutely cannot have the receipt scanned, you can as a last resort email or text (SMS) your reference/sequence number together with your full name, hash name, hash club, nationality and amount paid to +63 928 2572435 .
  • We will confirm your registration as soon as the payment is verified and runners who have registered will be listed on the website.

DISCLAIMER:
I acknowledge that in consideration of my being accepted as a participant in any events organized by Puerto Galera Hash House Harriers (hereafter known as PGHHH), I hereby release all persons and venues connected with the PGHHH organization from any litigious claims or actions whatsoever by me or my heirs, executors or assigns, arising from any injuries or death to me and any loss or damage to property belonging to me associated with my participation in the 12th Philippine Nash Hash 2011.

I have read the disclaimer and agree with the conditions