Dark Wood Farm - 2019 Community Supported Agriculture Sign up Form and Member Agreement
Primary Member Name *
Enter the name of the primary member in charge of weekly vegetable pick-ups and e-mail communication
Your answer
Primary Member Email *
Email is our primary form of communication with our CSA members. A valid email address is required to receive the weekly CSA newsletter, farm updates, event invitations, info on schedule changes, etc. We (your farmers) agree not to share your email address or any other personal information.
Your answer
Secondary Member(s) Name
If more than one person per CSA share would like to receive information about the CSA, newsletters, farm updates, schedule changes, etc, enter their names here.
Your answer
Secondary Member(s) Email
Your answer
CSA Box Label Name(s) *
The surname(s) you would prefer on your CSA box label at your pick-up location:
Your answer
Home Address *
Address, City, State, ZIP Code
Your answer
Phone Number *
Your answer
I understand that by joining the Dark Wood Farm Community Supported Agriculture (CSA) program, my farmers and I are entering into a relationship of shared risk and reward. My membership entitles me to the bounty of the harvest this season, but I understand there is also the risk of certain crop failures due to uncontrollable conditions.
Preferred Pick Up Location *
CSA shares will be delivered on Tuesday afternoons. We are considering several neighborhood pick-up locations. Please indicate your preferred neighborhood. We will choose five or six of these neighborhoods as final locations based on your preferences. Final locations will be confirmed prior to CSA season and you can switch locations, if needed, at that time.
Our 26-week CSA share is $610.00. You may either pay in full upon registration or opt to pay in two installments. The first installment of $300.00 will be due 2 weeks after this form is submitted and the second installment of $310.00 will be due by May 7th. Please note: online credit card payments incur an additional 3% fee. *
Required
I agree to pick up my weekly CSA share at my designated pick up location and time, and understand that there will be no refund or credit for late or missed pick-ups. Out of courtesy to our neighborhood hosts, please only gather your share within the designated pick-up time. *
Required
I agree to provide my own bags and/or cooler to transport my produce. *
Required
Pre-planned vacations or missed weeks: I agree to make my own arrangements to have someone else pick up my share during my planned absence -or- I will contact Annie at least one week in advance to have my share held in refrigeration until the next week, but understand that produce quality cannot be guaranteed if I choose this option. *
Required
I agree to pay for my share in full by May 7th, otherwise I will incur a $25 late fee. I understand that failure to pay for my share in full by May 14th will forfeit my CSA membership. *
Required
I understand that my farmers will reach out prior to CSA season to inform me of add-on options, to confirm my final pick-up location, and to poll me on my preferences for certain vegetables. *
Required
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service