EmailMe Form - Burnie H3 - Burnie Ten Weekend registration

Hash name

Hash chapter

Real name

Contact number

### - ### - ####

Email

Options

Saturday Run - run, food and hash bucket [$25]

Middle-Eastern Feast [$25]

Post-Burnie 10* - food, hash bucket, swim [$10]

or THE LOT [$55]

* you will need to register separately for the Burnie 10 – see www.burnieten.com.au for info

Oasis

Beer

Sparkling wine

Cider

Soft stuff

Payment

Cheque payable to: Burnie Hash House Harriers C/- PO Box 562, Burnie 7320

Direct deposit*: BSB 807 009, Account No. 5118 2967

* use hash name as reference and sent e-mail to dini@dhash.com to advise of funds transfer