OnLine Membership DESERT GOLD DIGGERS, INC. P.O BOX 5215 TUCSON, ARIZONA 85703 MEMBERSHIP APPLICATION Thank you for your interest in our club! We are a family orientated club with members from across the country! You must be over the age of 18 for an individual membership or we have a family membership that consists of you, your significant other and any children under the age of 18. (If you are under the age of 18 and are able to drive to claims you must have a guardian present or present a notarized waiver signed by parent/guardian to the membership director.) After payment of dues you will receive a new member packet with one ID Card; claim maps and claim information and your DGD name badge will be ordered. At least one adult name badge is required with membership. Other family name badges are optional and can be ordered for additional charges. Each membership entitles you access to all club claims, outings, socials and our club bi-monthly gazette. Your membership is good for one year from the date that you joined and must be renewed on your anniversary date listed on your ID card. All are invited to join our club however we reserve the right to cancel or revoke your membership for any circumstances deemed warranted by the DGD Board of Directors. DGD recommends that members never visit a club claim alone. We advise going with a partner or group and always tell someone where you are going and when you plan to return. Please indicate the purpose of the form. * New Member Annual Renewal Badge Order Name First Last Name Last Spouse's Name First (IF NONE PUT - N/A) Spouse's Last Name Last (IF NONE PUT - N/A) Mailing Address * Mailing Address Mailing Address Mailing Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Main Phone Number * Email Name to appear on primary badge required: * Name(s) to appear on optional badge(s) One Name Per Line Would you like your claims map on: * CD Paper Not Applicable for Renewals or Badge Orders I Acknowledge: * By affixing my signature to this application I acknowledge that prospecting and prospecting locations can be dangerous with numerous natural and artificial hazards. By signing up, as a member of the desert gold diggers inc. , i / my spouse / my family / and/or my guests agree to release the desert gold diggers inc., their officers or assignees and / or private property owner ( s ) from any liability incurred during prospecting operations / outings. I further agree to have any guests accompanying me to one of the “ clubs “ claims , on a private outing, to sign a “ club “ waiver prior to the outing. I Understand: * That if I am under the age of 18 and visit the claims without a guardian, a notarized waiver will be given to the membership director and I will carry a copy with me at all times while on club claims. How My Payment is Processed: * That once I submit this form I will be redirected to the Online Membership Payment Page. My payment will be process by PayPal. Signature Clear reCAPTCHA Submit
