CSA | Madison | Grassroots Farm LLC Monroe WI

CSA 2012 Agreement Form
Please complete this form and return with your payment, either through our website, or to the address below. You may pay through Paypal or Google Checkout, using our website, or by personal check or money order if sending this form to us by U.S. Mail.

Contact

Your Name(required)
Mailing Address(required)
City(required)
State(required)
Zip Code(required)
If you will be splitting a share, please designate one party as the responsible contact person. All parties can be on our mailing list, however. Simply add (comma-separated) e-mail addresses as necessary.
Preferred Method of Contact
E-mail Phone
Email(valid email required)
Phone Number(required)

Choose your pick-up location

Location(required)

Membership Information

Share Options
** Spring Shares Availible for Farm Pick-up only.**
Please note the cost of your share as the total will NOT be entered automatically in online payment section.
Please read through the following agreement:
Our Promise
In consideration of your seasonal membership, the Farm promises to deliver to your designated pick up point weekly (on the appointed day), one carton, as described in your selected Program below, full of certified organic vegetables and fruits primarily procured from our farm fields. As may be available and at no additional cost to the member, weekly share boxes may be supplemented with certified organic vegetables and fruits or other agricultural products locally sourced and of the same high quality as you have come to expect from Grassroots Farm.
My Agreement
I want to participate as a summer share seasonal subscription member in the 2012 CSA Program at Grassroots Farm, LLC. By submitting this form I accept all conditions and terms of this program, which are:
1. As a subscription member I fully accept sharing the risk of crop failure from all factors beyond the farmer's control, knowing that it may affect the availability of certain crops and the amounts that I will receive throughout the season.
2. As a subscription member I fully accept sharing the rewards of a bountiful season and the adventure of receiving a wide variety of certified organic, locally produced food products, some of which may be procured off farm, but all of which will meet the Grassroots Farm quality standard.
I agree to the terms and conditions stated above.

Method of Payment

Payment
Please note the cost of your share as the total will NOT be entered automatically in online payment section.

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Having Trouble with this form? Please download a PDF version here: Madison sign up form 2012 You can return it to farmer@grassrootsfarmllc.com or mail to:

Grassroots Farm, LLC
N4596 Dutch Hollow Rd.
Monroe, WI 53566

You can still pay online with Paypal http://www.grassrootsfarmllc.com/csa-checkout or Google Checkout http://www.grassrootsfarmllc.com/csa-checkout-google.

From time to time, as a bountiful harvest allows, our CSA members will be contacted via e-mail about special quantity purchase opportunities. These opportunities will be offered to you, our investors, first, before other customers, and will be priced according to the quantity you may wish to purchase. Special purchases are not included in the price of this subscription. Special purchases will be available for pick up with the CSA sharebox or as otherwise arranged.

Monroe, Wisconsin

Certified Organic Vegetables, Fruit, and Eggs
All Natural Pork, Poultry, and Cut Flowers

CSA | Madison

CSA | Madison

CSA 2012 Agreement Form

Please read through the following agreement:

Our Promise

My Agreement