2016 HASMB Accompany Travelers Medical & Contact Information
Attention All HASMB Accompany Travelers.

Please complete following contact & medical information questions.  Additional (i.e., Release) forms will need to completed as well which will be distributed at later date.  Children under 16 do not need to complete Section 5 -  Other Information.

Deadline to complete this information May 1, 2016.  
 

REMINDER
1. Download and sign Release Form from link below
     http://www.hasmb.com/forms.html
Forward to address as listed.

2. We would also like a recent photograph of each accompany traveler.
Please follow the direction below:
     * Take photograph against a white or light colored background.
     *  Hold by your stomach a white 8x11 piece of paper with your name printed neatly.
     *  Email your photo to Claire Kim - hasmb808@gmail.com.



Please contact Claire Kim if you have any questions - hasmb808@gmail.com.  

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Contact Information
Please complete following information.  Use name that is on your government ID that you will use to check-in at the airport.
First Name *
Middle
If on ID
Last Name *
NIck Name
Common Name that you would like used
Mailing Address
City
Zip
Street Address (if different than above)
City
Zip
Email Address
Secondary Email Address
Cell Phone
Is it ok receive and respond to text messages from HASMB personnel?
Clear selection
Home Phone
Work Phone
Name of Performer(s) that you are related to *
Relationship to Above Performer
Birthday *
MM
/
DD
/
YYYY
Gender *
Please indicate room type selected
Clear selection
Are you still in need of room mate?
Clear selection
Please list names of room-mates
Next
Clear form
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