LEAP Farm Share Registration
Please complete the registration form in its entirety. The name and contact information is for the primary Farm Shareholder. If you are splitting a share with a friend or family member and want more than one person to receive the weekly email reminder, you are welcome to provide more than one email address.

If you have any questions, please email farmshare@leapforlocalfood.org.

Farm Shareholder Name (First and Last) *
Your answer
Farm Shareholder Address *
Your answer
City, State, Zip Code *
Your answer
Farm Shareholder Phone (main) *
Your answer
Phone (secondary)
Your answer
Farm Shareholder Email (main) *
Your answer
Email (other)
Your answer
Which Main Season Shares would you like to participate in? (can choose more than one) *
Required
If you are purchasing a Winter Share, would you like the following customizations?
Pick-up Site for Veggie, Fruit, Medley, & Egg Shares (All Winter Shares must be picked up at the West End Farmers Market site) *
Main Season Vacation day #1 (between weeks of Apr. 30th & October 22nd)
MM
/
DD
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YYYY
Main Season Vacation day #2 (between weeks of Apr. 30th & October 22nd)
MM
/
DD
/
YYYY
Winter Share Vacation day if applicable (between weeks of Oct. 29th & Dec. 17th)
MM
/
DD
/
YYYY
Total Amount Owed *
Your answer
Payment (must be paid in full by April 16) *
Submit
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