GenGold^® Enrollment Application

I (We) herby accept this financial institutions offer to participate in the benefits program offered by Generations Gold Inc., and to receive specified discounts on various services. I (We) agree to pay the monthly fees after my 60-day free trial period. 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 providers. I (We) hereby authorize this financial insttution to release any information deemed necessary for participation in the GenGold® a fully independent benefits provider.

I (We) understand that I (we) must visit www.gengold.com and click on the Cash Back tab to securely register debit/credit cards to receive the Cash Back benefits. I (We) understand that I (we) must also access the Cash Back program through the GenGold® website each time I (we) shop online to receive the cash back rewards.

This Program is not insured by the Federal Deposit Insurance Corporation (FDIC) or any other federal government agency of the United States, the Bank or any affiliate of the Bank.