Harrisburg Community Garden Application

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Email *

First and Last Name *

Address *

Phone Number *

Best time to contact you? *

Emergency Contact Name *

Emergency Contact Number *

What size plot are you interested in? *

4ft x 8ft

4ft x 12ft

10ft x 10ft

Not Sure

Is there anything else you would like to share regarding your application? *

I have read and agree to abide by the Harrisburg Community Garden Guidelines. I hereby voluntarily release and discharge the Harrisburg Presbyterian Church, its agents, contracted services, servants, and employees from any and all claims for injury, illness, death, loss or damage which may occur as a result of my participation int he Harrisburg Community Garden. *

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