I (We) hereby accept The Merrimack’s offer to participate in the Mutual Benefits program offered by Generations Gold Inc., and to receive specified discounts on various services based on the membership level selected. I (We) agree to pay the monthly fee in accordance with the account disclosures and benefits package I (We) received. I (We) understand that The Merrimack makes no presentation, expressed or implied, regarding the quality of service and products provided by participants and shall have no liability in connection therewith. All liabilities, claims, damages and demands are the sole and direct responsibility of Generations Gold, Inc. and its independent benefits providers. I (We) hereby authorize Merrimack County Savings Bank to release any information deemed necessary for participation in the Mutual Benefits program to Generations Gold, Inc. I (We) understand that the benefits and services are provided by Generations Gold, Inc., a fully independent benefits provider.