Weekend Gold Miners Prospecting Club Inc Membership Application

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Name

Address *

City

State *

Zip *

Phone *

Email *

Spouse/Partner/Live-in Companion

Children under 21

HAVE YOU EVER BEEN A MEMEBER OF WEGM? (IF YES, WEGM BYLAWS require you to request a hearing from the Board of Directors to be re-instated as a member. This request must be in writing or email within 5 days of the next regularly scheduled monthly meeting.) *

Yes

Required

Release of Liability

I, recognize that mining and prospecting are inherently dangerous, and that the club's leases' have unmarked and unidentified hazards, to include abandoned mine shafts, caves, sink holes, steep slopes and other people, both invitees, licensees and trespassers and that any one or combination of the above can cause injure or death. I waive any claim against the Weekend Gold Miners Prospecting Club Inc or the land owners and covenant not to sue for any damages, injury or death caused to me or for the loss of equipment or personal items while on the leases. I further recognize that there are special dangers to minors and I shall assume all responsibility for each minor accompanying me, I further agree to carry such insurance as I feel necessary to protect my interest and to indemnify and hold harmless owners for any liability arising out of my actions while on the leases.

I agree

Required

FINANCIAL WAIVER

I being accepted as a member of the Weekend Gold Miners Prospecting Club Inc do hereby agree to abide by the by-laws and rules and regulations of WEGM. I understand that this is a contract for a $2000 membership, plus a $120 annual maintenance fee. I understand that if I do not pay my dues and maintenance fee, my membership will be terminated and I will be responsible for the remaining balance, unless approved by the Board of Directors. I must petition the Board of Directors to terminate my membership by sending a written request to: WEGM Board of Directors, PO Box 910 Dahlonega GA 30533. Upon approval of termination from the Board of Directors I must return my membership card and property gate key, if these items are not returned they can be repossessed by WEGM by whatever legal means necessary and that I may be held responsible for any cost of such legal action. I further understand that the total cost of membership is $2000.00* payable in monthly installments of $20.00* with a yearly maintenance fee of $120.00*. OR $1750* if paid in full on the date joined with a yearly maintenance fee of $120.00*.

*Subject to change

$2000.00 Lifetime Membership Payment Plan Option. $100.00 downpayment - I understand that I will receive an invoice to setup automatic payment at $30/month ($20 membership dues + $10 maintenance fees)

$1750 Lifetime Membership Paid in Full - I understand that I will receive an invoice to setup automatic payments of $10.00/month for annual maintenance dues

By typing your name below you are agreement to the above Release of Liability and Financial Waiver.

AFTER CLICKING SUBMIT CLICK THE BUTTOM BELOW FOR THE FORM FOR THE PAYMENT OPTION YOUR SELECTED AND COMPLETE YOUR PAYMENT.

You will receive an email with your membership number and details regarding your membership packet.

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