Waterbear Mountain Organic Farm 2013 CSA Membership SIGN UP FORM
All the information you need is on this form, please read it throughly before you send it in.
Name:_______________________________________ Email:_______________________________ Date:____________
Phone Number(s)_______________________________________________ Pick-Up Town:_________________________
*Pick-up towns: Roanoke, Blacksburg, Radford, Floyd. *All of your information is strictly confidential and will not be shared.
Buffet style pick-up only available in Roanoke and Blacksburg. Floyd and Radford shares will be boxed. A mini share is 15.00 A regular share is $22.50 if you would like to increase your size you may order more than one share of any size. We will deliver once a week. Pick-up locations and more information please refer to CSA web page 3 - How our CSA works. In 2012 we will deliver for a total of 28 weeks. We start on May 15th and end the third week in November. Bread, Egg and Meat are all added to cost of the produce share.
Price of Regular Share- $22.50 (1 share = $630.00 - 2 shares = $1,260 -3 shares etc..) __________.
Price of Mini Share - $15.00 (1 share = $420.00 - 2 shares =$840.00) __________.
Add Eggs-2 options
Locally grown but not organic $4.50 per dz (1 doz per week = $112.00, two doz a week = $224.00) __________.
Add Beef Share- 20 lbs, mixed cuts at $7.50 per lb (one share = $150.00) __________.
Add Pork share - 10 lbs, mixed cuts at $6.00 per lb (one share = $60.00) __________
If you cannot pay in full, divide your total by 2. First Payment Total ________.Second payment is due on August 1st.
Please make your checks out to Waterbear Farm. Payments can be sent to: Richard Ursomarso 477 Rain Dance Rd Floyd NE, Virginia. 24091. Questions? Please ask via email at: firstname.lastname@example.org. And now please tell us ten of your most favorite vegetables, with one being your most favorite.________________________________________________________________________________________________ I As a member of Waterbear Farm CSA I understand that the amount of produce and variety I receive may vary depending on circumstances beyond the farmers control. I understand that as a member I am sharing the inherent risks of farming. Waterbear Farm reserves the right to discontinue distribution and refund the remaining weeks for any member at any time. Signature:________________________________Date:___________.Thank You. We look forward to being your farmers and growing your certified organic, bio-dynamic food in 2011. Sincerely, Richie and Ilima Ursomarso