The
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 ________