NAME:

---

COMPANION (If Applicable):

---

ADDRESS:

---

CITY:                               STATE:                 ZIP:

---

HOME PHONE:

---

WORK PHONE:

---

E-MAIL:

---

EMERGENCY CONTACT:

---

NON-REFUNDABLE DEPOSIT (For Each Weeks Stay):

Prospector package $250.00

The Gold Miner package $350.00

Bring Your Own Equipment Package $200.00


INDICATE THE WEEK(S) YOU PREFER TO PROSPECT:

June 13 - June 19		July 18 – July 24
June 20 - June 26		July 25 – July 31
June 27 - July 3		August 1 – August 7
July 4 – July 10		August 8 – August 14
August 15 – August 21		July 11 – July 17

Please download the registration form, print it off, fill it out and mail to:
Goldfever Prospecting W2579 Hidden Lane Seymour, WI 54165 Phone: 920-366-0430 Fax: 920-833-2346 Goldfev@aol.com	After May 1st Gold Fever Prospecting Dean Race 77.5 Taylor Hwy Chicken, AK 99732
*Please include your deposit with the registration form (check or credit card information to be processed upon receipt).

After your reservation is confirmed and prior to departure, you will be asked to sign a waiver releasing Goldfever Prospecting of any responsibility.