Contact Information Sheet     Three Seasons Treasure Hunters

 

Name __________________________________________________

                 (Last)                       (First)                                    (MI)

Street Address ___________________________________________

Mailing Address (If Differant) _______________________________

City ____________________________ State ______ Zip ________

Home Phone ____________________ Cell Phone ______________

Fax _____________________ E-mail ________________________

Website ____________________________________________

Age _____ Date of Birth* _________________________

Emergency Contact ___________________ Phone ______________

If under 18 name or parent and phone number _________________

______________________________________________________

How Many Machines do you own __________ Yrs of Experience ____

What Make(s) ___________________________________________

______________________________________________________

______________________________________________________

Would you be willing to hold an officer (circle one) Yes  No Unsure

Would you be willing to serve on a committee (circle one) Yes No Unsure

Main area of interest (gold, coins, relics, lost items, evidence searches, please explain)

______________________________________________________

______________________________________________________

______________________________________________________

Please circle any information you DO NOT want published in a member directory. Only officers will have access to the information you wish to remain confidential.

 

* This information is necessary if you wish to participate in evidence searches to assist law enforcement. Participation in such activities may entail filling out a statement and testify in court. Would you be willing to assist law enforcement in such searches?

(Training will be provided prior to any such club sponsored activity)

Yes  No  Unsure

 

Family $25.00

Single $20.00

Youth $10.00