Please provide the following contact information (* are required fields): 下の空欄に記入してください。（*印のところは、必ず記入してください）
（記入は、英語かローマ字でお願いします。）
*Name 名前 Hash Nameハッシュ名前 Home Hashハッシュクラブ Mismanagement Title ミスマネージメント肩書き [please select] None Hash Master Grand Master Grand Mistress Grand Matress Religious Advisor Beer Meister Hash Cash On Sec Trail Master Hare Razor/Raiser Wired Sex/Webmaster Haberdasher Hash Scribe Hash Horn (press down the Ctrl key [Mac Users the Command Key] while clicking to make more than one selection) *Street Address 住所 Address *City 市, 郡―町 *Prefecture (State/Province) 県、府、都 *Zip/Postal Code 〒 *Country 国 Cell Phone 携帯電話 *Home Phone 自宅電話 FAX *E-mail メール
(press down the Ctrl key [Mac Users the Command Key] while clicking to make more than one selection)
For purpose of Alcohol Consumption, Food, Goodie Bag, Run Planning & Accommodations: 未成年はお酒を飲めません。必ず記入してください。
*Date of Birth 生年月日 日/月/年 *Gender 性別 Male男性 Female 女性
*Beverage Preference 何を飲みたいか [choose one] Beerビール Chuhai 酎ハイ Sake 日本酒 Wineワイン Soft Drinksソフトドリンク
*Food Preference 何を食べたいか [choose one] Carnivore 肉食動物 Omnivore 雑食動物（何でも食べる） Pollo-herbivore 卵･鶏肉・草食動物（菜食主義者） Pesco-herbivore 魚・草食動物（菜食主義者） Ovo-Lacto herbivore 卵･牛乳店・草食動物（菜食主義者） Lacto-Herbivore 牛乳店・草食動物（菜食主義者） Strict Herbivore 草食動物（菜食主義者）
Please indicate below any Food Allergies or Foods that you can not eat: 食べ物のアレルギー体質があるし食べ物を食べれないことができません下で書いて下し
*Choose which size T-Shirt you'd preferシャツのサイズを選んでください:
XS S M L XL XXL
*Choose which size socks you'd prefer靴下のサイズを選んでください:
S/M (US size 6-10, 日本の靴サイズ24-28) L/XL (US size 9-13, 日本の靴サイズ27-31)
*Choose what type of trail you want to run: [choose one] FBAC Stroll 5km> めちゃめちゃ短い Medium 5-10km ふつう Long 10-15-km 長い Ball Buster 15-20km めちゃめちゃ長い トレールの長さを選んでください:
Please indicate below if you have any accommodation preferences. 宿泊設備の好みを選んでください:
No Preference どれでもいい Staying with Pets ペットを持っています Women Only Cabin 女だけ用ケビン Family Cabin家族用ケビン
Children子供 Pets ペット
PREVIOUS NASH HASH ATTENDED*
We the IWSH3 Disorganizers would like to honor hashers in accordance to how many Nash Hashes they have attended.
[choose as many as appropriate] Japan Nash Hash Virgin 2006 Sanda hosted by KKK 2005 Okutama hosted by TLH3/TH3 2004 Lake Yamanaka hosted by Sumo H3 2003 Inbu Beach hosted by Okinawa H3 2002 Miyajima hosted by IWS H3 2001 Gifu hosted by Nagoya H3 2000 Sanda hosted by Kobe H3 1999 Jogashima hosted by Samurai H3 1998 Okinawa hosted by Okinawa H3 1997 Misawa hosted by Misawa H3 & Tokyo H3 1996 Kobe hosted by Kobe H3 1995 Tama Lodge hosted by Samurai H3 1994 Chiba hosted by Full Moon Rising 1993 1992 1991 1990 1989 1988 1987 1986
PAYMENT
Choose which attendance package and then choose method of payment. (You will need to get us your money to reserve your space if you chose Cash then it is your responsibility to us the money by the deadlines). With all money transfers be sure to include your full name, duhh? but you'd be surprised how many people forget.
* Attendance Package 出席プラン [choose one] Full Package 1 Night * Form of Payment支払い方法 [choose one] Cash in Person 現金 Cash by Certified Mail 現金書留 Japanese Bank 振込み(furikomi) US Bank Account Check US Bank Electronic Transfer Wire Transfer to Japanese Account Wire Transfer to US Account
TRANSPORTATION
*Transportation to Miyajima [choose one] Car 車 Local Train 電車 Shinkansen 新幹線 Airplane 飛行機 Undecided また分からない どうやって宮島へ来るか?
Out of Town Applicants 県外から来る場合 Fill in additional information so we assist you in your stay 下の項目に記入してください。私たちが、相談にのります。
Extended Accommodation Needs No Thanks Need Local Hotel Info Need a Couch to Crash on
Any additional comments, questions or special requests please provide in the space below