WPA Application

Wyoming Prospector's Association Membership Application

First Name:

Last Name:

PO Box:

Street Address:

City:

State:

Zip:

Phone:

E-Mail Address:

Spouse Name:

RELEASE IN FULL OF ANY AND ALL CLAIMS For and in consideration of being a member of the Wyoming Prospector's Association, I/We hereby acquit and forever discharge the Wyoming Prospector's Association, it's members, directors, officers and any other persons, firms, entities or corporations of any and all actions, claims, demands, costs, loss of service growing out of any and all known and unknown personal injuries and or property damage resulting from any accidents that could occur on any of the club owned or leased properties or at any club sponsored activity on the property of others and not club owned or leased.
I/We state that I/We have obtained, read and will abide by the, Prospectors Code of Ethics, of the Wyoming Prospectors Association..
Click here to read Prospectors Code of Ethics
We, the undersigned, do hereby state that we have not been influenced to any extent whatsoever in making this release by any representations or statements regarding said injuries or liability or other matters made by the club, its members, directors or officers hereby released or by other person(s) representing or acting for them. This release contains the entire agreement between the parties hereto and the terms of this release are binding and contractual. We further state that we have carefully read and understand the foregoing release and know the contents thereof and I/We sign the same as our own free act.

Membership(s) Signatures: Date: .

Family membership to the Wyoming Prospector's Association is $50 per year for residents.
Year defined as: Application date + 364 days.
Family is defined as: Couple plus children under age of 18 living in your place of residence for whom you are responsible for.
Residency is defined as: Resident means a United States citizen or alien who has been a resident of Wyoming and domiciled in Wyoming for not less than one (1) full year (365 days) and who has not claimed residency elsewhere for any other purpose (such as, but not limited to, voting, payment of state income taxes as a resident, purchase of resident hunting, fishing, and trapping licenses, etc.) during that one (1) year period immediately preceding the date of application for or purchase of a license, permit or certificate.
All active military personnel will be considered as a resident.
$150 per year for non-resident family membership.
Submit your completed application at a monthly club meeting or mail with payment to:
WPA PO Box 1269 Riverton WY 82501

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