Rocky Mountain Prospectors & Treasure Hunters Club

Membership Application

First Name:      

Last Name:      

Street Address:

City:

State:

Zip:

Phone:

Email Address:

Individual Membership: [   ]

Family Membership: [   ]

Family Members & Relationship:

I elect to receive monthly newsletter via Internet download:  [  ]

Personal Interests (place an X beside your interests):

Prospecting: [   ]

Gold Panning: [   ]

Gold Sluicing: [   ]

Gold Dredging: [   ]

Hard Rock Mining: [   ]

Coin Shooting: [   ]

Detecting in Water: [   ]

Nugget Shooting: [   ]

Relic Hunting: [   ]

Cache Hunting: [   ]

Treasure Hunting: [   ]

Bottle Hunting: [   ]

What else should we know about your interests, experience or capabilities?

 

RELEASE IN FULL OF ANY AND ALL CLAIMS

For and in consideration of being a member of the Rocky Mountain Prospectors and Treasure Hunters Club, I/We hereby acquit and forever discharge the Rocky Mountain Prospectors and Treasure Hunters Club, it’s members, directors, officers and any other persons, firms, entities or corporations of any and all actions, claims, demands, costs, loss of service growing out of any and all known and unknown personal injuries and or property damage resulting from any accidents that could occur on any of the club owned or leased properties or at any club sponsored activity on the property of others and not club owned or leased.

We, the undersigned, do hereby state that we have not been influenced to any extent whatsoever in making this release by any representations or statements regarding said injuries or liability or other matters made by the club, its members, directors or officers hereby released or by other person(s) representing or acting for them. This release contains the entire agreement between the parties hereto and the terms of this release are binding and contractual. We further state that we have carefully read and understand the foregoing release and know the contents thereof and I/We sign the same as our own free act.

 

Member(s) Signatures:

Date:

Membership in the Rocky Mountain Prospectors and Treasure Hunters Club is $30 per year for either individual or family. Submit your completed application at a monthly club meeting or mail with payment to:

RMPTH, P.O. Box 1863, Fort Collins, CO 80527-1863