Gold Searchers of Southern Nevada Membership Application.

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! PLEASE PRINT CLEARLY !

Application to: Gold Searchers of Southern Nevada, Inc.

P.O. Box 96732
Las Vegas, NV. 89193-6732
Phone: (702)-897-2437
www.goldsearchers.info

I understand that as a member of the Gold Searchers of Southern Nevada, Inc., I can run for office and
participate in the voting on all major policies and officer elections. I will also be able to attend all meetings and
use the club claims, subject to the club Bylaws. I can also use club equipment by appointment and check out
book's and video's from our extensive Library.

I/we, the undersigned, (hereafter referred to as Participant) assume all risk and/or hazards associated with
participants involvement in the Gold Searchers of Southern Nevada, Inc., a prospecting club. Participant(s) agree
to indemnify and HOLD HARMLESS all club officers, sponsors, and/or other third, fourth, etc., parties involved in
club activities. Participants realize that metal detecting, gold prospecting, and associated activities can be
dangerous. The terrain can be hazardous and there may be wild or domesticated animals and snakes present.
Some locations may have open shafts, pits, and tunnels. Participants assume all responsibility by signing below.

SIGNATURE .

HOLD HARMLESS AGREEMENT

==========DO NOT REMOVE OR SEPARATE====================FOR OFFICIAL USE ONLY==========

CLUBS ONLY FUNCTION IF MEMBERS VOLUNTEER
I/we will volunteer to assist in the areas checked. Please check at least one area.

COMMITTEES

[ ] OUTINGS [ ] FOOD [ ] CLAIMS [ ] EDUCATION/TRAINING [ ] NEWSLETTER

[ ] MEMBERSHIP [ ] WEBSITE [ ] LIBRARIAN

ELECTED OFFICES

[ ] PRESIDENT [ ] VICE PRESIDENT [ ] SECRETARY [ ] TREASURER [ ] MEMBERSHIP

As of January 1st, 2008., Dues are payable on the first of the Month of your Anniversary date. New Members
$60.00 and to Renew is $40.00.

CHECK                                                           CASH                                                      BY

RECEIPT                                                        FROM                                                     TO

CARD #                                                          CARD SENT                                      CLAIMS BOOK SENT

DEDICATED TO THE PURSUIT OF GOLD!

REVISION: 1B 09/18/2008