FIELD TRIP RELEASE OF LIABILITY

Pertaining to all Scheduled and Sanctioned Activities and Field Trips of the Western Dakota Gem and Mineral Society (WDGMS). My signature on this document is effective from this date:

 My 'one time signature' signifies I will abide by the Field Trip Rules, Claims, Safety and Release of Liability Document.

By signing below, I acknowledge that activities sponsored or conducted by the WDGMS may be hazardous and take place in remote locations and may result in loss, damage, injury, or death.

With full knowledge of these dangers, I hereby agree for myself, all of my family and my heirs to RELEASE the WDGMS and any of their officers, representatives, field trip leaders, committees, members, or other trip or activity participants from liability, claims, demands, or any cause of action, and NOT TO SUE OR OTHERWISE MAKE ANY CLAIM against the WDGMS or any of their officers, directors, members, field trip leaders, committees, representatives, trip participants or affiliate clubs whatsoever which may arise during my participation or travel to and from any activities of the WDGMS.

I intend this RELEASE OF LIABILITY to be effective whether or not any loss, damage, injury, or death RESULTS FROM NEGLIGENCE of the WDGMS or any of their agents, leaders, officers, directors, representatives, trip or activity participants or affiliate clubs. I understand that negligence means a failure to do an act that a reasonable, careful person would do, under the same similar circumstance, to protect him, herself or others from injury or death.

I hereby further agree for myself, all of my family and my heirs to RELEASE the mine owners, property owners or claim holders of the site that a field trip or activity is held or any of their directors, officers, representatives or agents from liability, claims, demands or any causes of action and NOT TO SUE OR OTHERWISE MAKE ANY CLAIM against mine owners, property owners or claim holders, their officers, directors, representative or agents whatsoever which may arise during my participation in any activities of the WDGMS.

I have read and understand the terms of this Release of Liability and the Field Trip Rules, Claims, Safety Document of the WDGMS. I agree to be solely responsible for my own safety and to take every precaution to provide for my own safety and wellbeing while participating in activities of the WDGMS.

PERTAINING TO NON-MEMBER MINORS (UNDER THE AGE OF 18): A PARENT OR LEGAL GUARDIAN MUST READ AND SIGN BELOW:

I am the legal

of

and have read the Release of Liability and the Field Trip Rules, Claims, Safety Document of the WDGMS. I hereby consent to the terms of this Release of Liability and Field Trip Rules, Claims, Safety Document on behalf of the above named minor(s) and give my consent to the participation of the above named minor(s) in all activities of the WDGMS stated above. This named minor(s) will be at all times under the supervision of club member(s):