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| (Click here for a reg with a white background) | |||||||||
COTEX V Registration Form |
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| Name:___________________________________________________________________ | |||||||||
| Hash Name:______________________________________________________________ | |||||||||
| Home Hash: _____________________________________________________________ | |||||||||
| Email:___________________________________________________________________ | |||||||||
| Phone___________________________________________________________________ | |||||||||
| Address:_________________________________________________________________ | |||||||||
| Sex: M F | Shirt Size:___________________________________________________ | ||||||||
| Enclosed $69.69, payable to Michael D. Barton post marked by 15 May, 2004. | |||||||||
| I ________________________(printed name) do understand that if I hurt myself, it's my own damn fault! I cannot / will not fault or blame the COTEX management, TRACTOR Brewery, Budget Inn or the city of Santa Fe, New Mexico. Date _______________________ Signature ___________________________________ |
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