United Prospectors, Inc. Membership Application
Membership is open to anyone interested, 18 years or older. One membership includes a spouse & children under the age of 18.
All memberships are good for a period of 1 year and will expire on your anniversary date.
Membership Dues: (check your preference below) Number of qualifying family members
Annual Membership $45.00/year: New Renewal Lifetime Membership $450.00: Foreign Countries $55.00/year:
Name: Phone:
Address: E-mail Address:
City: State: County: Zip code:
Country:
How did you hear about us? _________________________Contra Costa UPI Website________________
Yes , I want to receive the newsletter and renewal reminders electronically. If you checked yes, please make sure you have included an email address above.
I hereby apply for membership/renewal with United Prospectors, Inc. (“United Prospectors”). I understand that United Prospectors and its agents do not provide goods or services for my activities including, for example, mining equipment or supplies, lodging, transportation, food service, etc. United Prospectors is not liable for any negligent or willful act or failure to act by providers of such goods or services during my activities. I acknowledge that there may be certain risks involved with activities as a member including, but not limited to, rugged or uneven terrain, uncertain or unpredictable river currents, physical exertion for which I am not prepared, other unknown forces of nature, high altitude, accident or illness without access to means of rapid evacuation or availability of medical supplies, the adequacy of medical attention once provided, or negligence on the part of United Prospectors. I HEREBY AGREE TO BE RESPONSIBLE FOR MY OWN WELFARE AND ACCEPT ANY AND ALL RISKS OF UNANTICIPATED EVENTS, ILLNESS, INJURY, EMOTIONAL TRAUMA, OR DEATH. I acknowledge that the cost of United Prospectors memberships is based upon participants executing this Release of Liability. Therefore, as lawful consideration for being permitted to participate as a member, I hereby RELEASE AND DISCHARGE FOREVER UNITED PROSPECTORS FROM AND AGAINST ANY AND ALL LIABILITY ARISING FROM MY MEMBERSHIP OR MY ACTIVITIES AS A MEMBER. I agree that this release shall be legally binding upon me personally, all members of my family and all minors traveling with me, my heirs, successors, assigns, and legal representatives, it being my intention to fully assume all the risk associated with my activities as a member and to release United Prospectors from any and all liabilities to the maximum extent permitted by law.
I AM 18 YEARS OR OLDER AND HAVE READ AND FULLY UNDERSTAND THIS RELEASE AND MEMBERSHIP APPLICATION.
Signature: __________________________________________________ Date: UPI Member #: (Renewal Only)
Please mail this completed (signed and dated) application along with your check/money order to:
United Prospectors Inc.
PO Box 693284
Stockton, CA 95269-3284
Please allow 4 weeks for your application to be processed
Revised January, 2022