NAME:

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COMPANION (If Applicable):

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ADDRESS:

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HOME PHONE:

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WORK PHONE:

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E-MAIL:

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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:

May 31 – June 6		July 19 – July 25
June 7 - June 13		July 26 – August 1
June 14 - June 20		August 2 – August 8
June 21 - June 27		August 9 – August 15
June 28 – July 4
July 5 – July 11
July 12 – July 18

Please Mail this registration page along with deposit to:

Goldfever Prospecting
W2579 Hidden Lane
Seymour, WI 54165
Phone: 920-366-0430
Fax: 920-833-2346
Goldfev@aol.com



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