Community Garden Registration 2024
Please complete the form below to secure your garden plot for the 2024 season. If there are multiple gardeners registering for the same plot(s), please fill out demographic and contact information for ALL liable renters. We look forward to growing with you!
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First Name *
Last Name *
First Name
Last Name
Address *
City, State, Zip code *
Secondary Address
Secondary City, State, Zip Code
Primary Phone *
Secondary Phone 
Email 1
Email 2
View garden plot map to choose your preferred plots. Any white space is available to choose; however, returning gardeners will receive priority choice for plots. The Community Gardens Coordinator will contact you to confirm your plot number.
Link to Garden Map
Preferred Plot Numbers *
Number of plots *
Size
Total Owed: *
If you have questions, contact the Extension Fond du Lac County Community Garden Coordinator, Patty Percy, at patty.percy@wisc.edu or 920-929-3172.
If you would like immediate assistance, please contact Tina Engelhardt at tina.engelhardt@wisc.edu or 920-929-3171.
Please complete this form and mail payment to: Extension Fond du Lac County, 400 University Drive, Rm AE-227, Fond du Lac, WI 54935 or call 920-929-3171 to pay by card.
Please provide the following demographic information about yourself(s).
This information is used to ensure our programming is reaching a diverse audience and to fulfill our obligations as a recipient of federal funding. You reserve the option to not provide this demographic information.
1. Please indicate your race(s) (Check all that apply):     *
Required
2. Please indicate your ethnicity(s): *
Required
3. Please indicate your sex(s): *
Required
4. Please indicate your age(s): *
Required
Extension Fond du Lac County Community Gardens 2024 Waiver & Release of Liability
I have reviewed, understand, and agree to abide by Extension Fond du Lac County’s policies relative to the use of the Community Gardens and the conditions set forth therein. I/We understand that gardening is considered a recreational activity. I/We agree to abide by all Extension Fond du Lac County Community Garden Rules and understand that the use of the Community Garden may be denied if rules are not followed.
I/We understand and am/are aware that gardening, including the use of tools, equipment, insect control products, and chemical fertilizers, is a potentially hazardous activity and involves a risk of injury, death and property damage. I/We hereby agree to expressly assume and accept all risks associated with gardening and the use of the Community Garden including, but not limited to, those caused by terrain, facilities, soil conditions, temperature, physical exertion, insect/rodent exposure, chemical exposure and actions of other people.

Disclaimer
Agency partners do not assume responsibility for the mishap of injury on state or county property, nor are the agency partners responsible for accidental or intentional acts of vandalism or other unforeseen harmful garden acts by person(s), animal(s), or weather.
   
Garden plot renters agree to follow the guidelines and regulations established for the garden season. Any incidents occurring on their plots or at the garden site shall be the renters’ liability.
Any materials left on garden sites including cages, fences, and stakes shall be discarded after closing date.

Disregard of garden rules and any gardener who fails to comply with the garden clean-up policy will lose the privilege of using the Community Gardens.

 

Signature (type name) *
Signature 2 (type name)
Today's Date *
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An EEO/AA employer, University of Wisconsin-Madison Division of Extension provides equal opportunities in employment and programming, including Title VI, Title IX, the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act requirements.
Please check if you are interested in volunteering in the garden.
For more information:
https://fonddulac.extension.wisc.edu/hort/fdlgarden/ 
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