|
|
|
MEMBERSHIP . . . .TO PRINT: Select "PRINT" from browser toolbar
Membership is open to anyone 18 years of age or older. A family membership includes applicant, a spouse or significant other and their children under 18 years of age
YEARLY DUES.....................STUDENT.........INDIVIDUAL.........FAMILY
New .............................................$60.00....................$65.00.....................$75.00
Renewal........................................$30.00....................$35.00.....................$45.00
LIFETIME MEMBERSHIP.......................................$300.00..................$450.00
Lifetime memberships must be paid in full within two (2) years; but within that time period, yearly dues must be paid.
I’m interested in: ____ Placer Mining ____ Metal Detecting ____ Dry Washing ____ Other ProspectingSign me up as a: _____ New Member _____ Renewing Member _____ Age
Equipment Owned: _______________________________________
Enclosed is a: ____ Check ____ Money Order in the amount of $ ________________
Please PRINT the following information (include spouse/significant other if this is a Family Membership):
NAME(S): ________________________________________ Phone: _(______)__________________
ADDRESS: ________________________________________________________________________
CITY: ______________________________________ STATE: ________ ZIP: ________________
Email address: ___________________________________________________________
I hereby apply for membership in COMSTOCK GOLD PROSPECTORS. I, the undersigned, fully understand that whatever recreational event I or my family attend, I am fully responsible and at no time will have legal or financial claim against, nor will hold responsible, any member or club officer of COMSTOCK GOLD PROSPECTORS, for any damages or injuries received by my participation in any event. I will be responsible for my own actions and the actions of my family or guests. I HAVE READ AND FULLY UNDERSTAND THIS RELEASESIGNATURE: ____________________________________ DATE: _______________
MAIL TO: COMSTOCK GOLD PROSPECTORS, PO BOX 20781, RENO NV 89515-0781
Revised 112407