I (We) hereby accept the offer of Fowler State Bank to participate in the benefits program offered by Generations Gold Inc. I (We) agree to pay the monthly fees as noted above and on the bank's Fee Schedule which may change without notice. I (We) understand that this financial institution makes no representation, expressed or implied, regarding the quality of service and products provided by the participants and shall have no liability in connection therewith. All liabilities, claims, damages and demands are the sole and direct responsibility of Generations Gold and its independent benefits program. I (We) hereby authorize Fowler State Bank to release any information deemed necessary for participation in the GenGold® program. I (We) understand that the benefits and services are provided by Generations Gold Inc., a fully independent benefits provider and not Fowler State Bank.
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