2014 FARM SHARE AGREEMENT Youth Farm CSA

MEMBER INFORMATION o School Staff! Name/s:

Please include names of all people sharing membership

o Family of Student! !

o Community Member!

Address: Phone: Email:

We believe that all people, regardless of their income level deserve healthy fresh food. Therefore, we have a sliding scale cost for our Farm Share based on your income level & family size. We ask that you be generous and pay within your means. We suggest that individuals earning less than $30K give at the medium level, and $40K at the higher level. Individuals and families on public assistance or part of HSPS please feel free to join at the lower cost.

MEMBERSHIP LEVEL: o Low Cost Share: $500 o Medium Cost Share: $550 o Higher Cost Share: $600

CSA membership fees are NOT tax-deductible. PAYMENT OPTIONS:

o Full Payment: Include a check for the total share cost by 6/1/2014 o Installment Plan: Include 2 checks or money orders for 1/2 the total cost, one dated 6/1/2014 and one dated 8/25/2014.

PICKUP LOCATION:
o WEDNESDAY 2:30 pm - 6:30 pm at the Youth Farm (600 Kingston Avenue) o MONDAY 5 pm - 8 pm at Shambhala Yoga (367 St. Marks Avenue) Shambhala Pickups: If you will not be able to pick up your share, please notify the studio!in advance!by emailing!contact@shambhalayogadance.com, or calling (646) 651-2413, and they will put it aside for you.
FARM SHARE CSA MEMBERSHIP AGREEMENT:

I commit to membership in the 2014 Youth Farm CSA. I will pick up my share every week from June 16 through November 10 (Shambhala pickup), or from June 18 through November 12 (Youth Farm pickup). If I am unable to pick up my share, I will have a friend or relative pick up for me, or forfeit my share that week. I understand that CSA involves sharing the rewards and risks with the farm. I understand that my share may vary from week to week, and that there is no guarantee of the exact amount of my share. I agree not to hold Green Guerillas, the High School for Public Service, BK Farmyards, or anyone acting on its behalf, including any agents, ofcers, volunteers or employees, responsible for any damages resulting from injuries sustained while engaged in any event or activity, including but not limited to weekly distribution or volunteer days.

or for other related endeavors. This authorization is continuous and may only be withdrawn by my specic rescission of this authorization. Through membership in the HSPS Youth Farm CSA I am supporting a local food system and bringing healthy food to our community. I have read this agreement and agree to the terms:

Signature!

Date

Please make checks payable to: Green Guerillas

Please write CSA in the memo line.

Mail application and checks to: Green Guerillas 232 E. 11th Street New York, NY 10003

I hereby authorize Green Guerillas and HSPS to use, reproduce, and/or public all written and/or Membership is granted on a rst-come, rst serve visual materials, including photographs, that may basis with preference given to HSPS parents. pertain to me. I understand that this material may be used in various publications, public affairs releases, recruitment materials, For more information, visit www.hspsfarm.blogspot.com