Havasu
Gold Seekers, Inc.
P.
O. Box
3281 Lake
Havasu City
,
I/We, the undersigned, (herein after referred to as Participant) assume all risks and or hazards associated with Participant’s involvement in the Havasu Gold Seekers, Inc. Prospecting Association. Participant agrees to indemnify and hold harmless all Club Officers, Sponsors and/or other third, fourth, fifth, etc. parties, or club member involved in any club activities.
Participant realizes that metal detecting, gold prospecting, and associated activities can be dangerous. The terrain can be hazardous, and there may be wild and domestic animals, insects, snakes, etc. present. Some locations may have open shafts, pits and tunnels. Some areas may be suitable only for four-wheel drive vehicles.
Participant assumes full responsibility for any injury, loss, or liability, which may result or be alleged to have resulted from involvement in these activities. This includes, but is not limited to, loss of life, limb and sight. Loss and liability is also accepted for, but limited to metal detector, mining equipment, pets and vehicle. This agreement includes the trip to and from actual location of Havasu Gold Seekers, Inc. properties and claims.
In case of injury or sudden illness, Participant hereby accepts needed first aid and gives authorization to any hospital, doctor or emergency personnel to render immediate emergency aid as may be required at the time for Participant’s health and safety. It is understood by Participant that Participant accepts the expense of professional services.
This document applies to any and all activities while on Havasu Gold Seekers, Inc. properties or claims in which Participant is involved. It applies not only to the date of signature, but also, to any and all future dates. This document will be in affect until and unless written revocation is received.
Signature of Participant ______________________________ Date __________
Signature of Participant ______________________________ Date __________
Name(s) of Minor Children __________________________________________
Signature of Parent(s) or Legal Guardian(s)
__________________________________________________ Date __________
__________________________________________________ Date __________
All Members and Guest must have this Agreement signed and on file with Club Office.
REV. 3/08