The Delaware Valley Paleontological Society


Send Completed form to:
     Stephen Kurth
     37D Monroe Path
     Maple Shade, NJ 08052

2006-2007 MEMBERSHIP FORM
  DVPS Dues:      ___   $20 Individual     ___   $25  Family   ___  $18 Student
  Make checks payable to  DVPS  or Delaware Valley Paleontological Society

   PLEASE PRINT!
  Names(s) _____________________________________________________
  Address   _____________________________________________________
  City  __________________________  State  ____    Zip  ______________
  Country (other than US) _________________________
  Phone (H)  __________________________  Work ________________________
  e-mail address  _____________________________________
  ___ Check this space if you do not want your information placed in our club directory

Delaware Valley Paleontological Society Field Trip Release Form for 2006-2007

The undersigned, in consideration of the privilege of attending field trips related to the collection and/or study of fossils, or any other event or activity conducted or hosted by the Delaware Valley Paleontological Society (DVPS) , such trips, events, and activities hereinafter being referred to individually as "Field Trip" and collectively as "Field Trips", hereby release the DVPS and all officers, Field Trip Leaders and members of the DVPS from any and all liability with respect to injury to person or property of the undersigned, free from cause whatsoever, which may occur while the undersigned or said's children are attending or
participating in any Field Trip.
The undersigned hereby acknowledges his/her understanding that fossil collecting is an inherently dangerous activity which can result in serious bodily injury or death,
and hereby confirms his/her voluntary assumption of the risk of such injury or death. The undersigned agrees to comply with any and all rules and restrictions which may be communicated to the undersigned by the DVPS and/or landowner with respect to the Field Trip.  This release is being signed with respect to all Field Trips conducted by the DVPS, until such time as the undersigned shall revoke this Release
by written notice to the President of the DVPS.

IN WITNESS WHEREOF, and intending to be legally bound, the undersigned has signed this Release.

Name _________________________  Signature __________________  Date ________

Name _________________________  Signature __________________  Date ________

Name _________________________  Signature __________________  Date ________

Name _________________________  Signature __________________  Date ________