Upland Hills CSA, Oxford, MI, 2009 Application Form

Hello! We are excited and thinking green because of all the plans and energy that have been given to the Upland Hills
CSA project. We are planning for our season to start sometime in June and run into September for a total of 16 weeks.
60 Shares being sold on a first come first serve basis!

Last Name First

Street
City State Zip
Home Phone Work Phone Cell
E-mail Number of People in your household:
Group email is invaluable for communicating to our members. Will you read our emails? Yes____ No____

Type of Share (please choose one, a $100 deposit today, reserves your share)
_____ Full Share: $500 = 16 weeks
_____ Working Share: $400 = 16 weeks
Work shares; expect 2 hours per week depending on number of work shares. Work shares will be
billed as a full share if 3 working periods are missed.

I prefer to pay:

_____ In Full - Payment due at sign-up

_____ Monthly - Full Share: $100 at sign-up and $100 per month for 4 months
_____ Monthly - Working Share: $100 at sign-up and $75 per month for 4 months
(Please make checks out to: Upland Hills CSA)

Pick-up Days and Times

Please rank your first (1) and second (2) preferred pick-up days and times.
_____ Monday _____ Morning
_____ Tuesday _____ Noon
_____ Wednesday _____ Afternoon
_____ Thursday _____ Evening
_____ Friday
_____ Saturday

Shares are available for pickup twice per week, days and times to be determined.
Other pickup sites to be determined, estimated extra $50 fee.

What veggies do you like the most?

Please rank the following vegetables by preference
(1) A Must, can’t get enough (4) A little goes a long way
(2) A Favorite, use large quantities (5) I wouldn’t eat it as a kid, I won’t eat it now
(3) Use moderate amounts

_____ Basil _____ Leeks _____ Sweet Corn

_____ Beets _____ Lettuces _____ Tomatoes
_____ Broccoli _____ Onions _____ Turnips
_____ Brussels Sprouts _____ Parsley _____ Watermelon
_____ Cabbage _____ Parsnips _____ Winter Squash
_____ Cantaloupe _____ Peas _____ Zucchini
_____ Carrots _____ Peppers (hot) _____ Asparagus
_____ Cauliflower _____ Peppers (sweet) _____ Strawberries
_____ Cilantro _____ Potatoes _____ Rhubarb
_____ Cucumbers _____ Pumpkins _____ Other
_____ Eggplant _____ Radishes _____ Other
_____ Garlic _____ Rutabagas _____ Other
_____ Green Beans _____ Scallions _____ Other
_____ Kohlrabi _____ Summer Squash _____ Other

I would like to participate in the following farm activities: (optional)

_____ Greenhouse work _____ Field Work _____ Harvesting
_____ Planning Committee _____ Newsletter _____ Advertising
_____ Cooking Classes _____ Canning _____ Picnics
_____ Hay Rides _____ Seasonal Celebrations _____ Other

Organic Certification:
_____ Means a Lot to Me
_____ Is important
_____ I can see how you farm, certification is not necessary
_____ I just want fresh and local, organic is not that important to me

I understand that I am buying a share in a community supported farm, not a specific amount of
produce. I am entitled, though, to my equal share of the farm production. I understand that there are
risks involved in farming, and I am willing to share those risks with this farm in order to secure my
food source.

Signed Date

Please mail this application to: Upland Hills CSA

C/O Scott LaFond
221 Baldwin Ave.
Royal Oak, MI 48067

248-823-1876 phone
877-572-6088 fax
Email: uplandhillscsa@gmail.com
 Liability Waiver for Members and Guests –All participating Adults must sign this wavier
(Both parents of minor children must also sign)

The undersigned on her/his behalf AND on behalf of any minor who the undersigned is a parent or guardian, agrees to release the owners of real
and personal property owned, leased or rented by Upland Hills CSA, its owners and workers for the loss, expense, claim or cause of action,
however caused, arising directly or indirectly from participating in any Upland Hills CSA’s activity whether on or off property owned by Upland
Hills CSA or its owners and/or members.

I do hereby agree to waive and relinquish all claims I may have against Upland Hills CSA and its owners, officers, members, agents, workers and
employees from any and all claims for injuries, damage or loss that I may have or which may accrue to me as a result of my participation in Upland
Hills CSA.

The items and issues agreed upon in this paragraph shall survive beyond the expiration, or otherwise termination, of the membership share
agreement. I further agree to indemnify and hold harmless and defend Upland Hills CSA and its owners, officers, members, agents, workers,
assistants, interns and employees from any and all claims for injuries, damage or loss sustained by me and arising out of, connected with, or in any
way associated with the activities of Upland Hills CSA.

Upland Hills CSA may use other properties not owned by the Websters to grow produce of which I do hereby agree to waive and relinquish all
claims I may have against those owners, officers, members, agents, workers, assistants, interns and employees from any and all claims for injuries,
damage or loss that I may have or which may accrue to me as a result of my participation in activities at said properties.

__________________________________ _______________________________________
Signature Signature

__________________________________ _______________________________________
Print Name Print Name

Date________________________ Date_______________________

2009 Upland Hills CSA Share Agreement

Please read and sign the following:

I wish to support Upland Hills CSA. I understand that the CSA is committed to growing crops as designated in the crop production
plan, to the best of their abilities, weather permitting.

I understand that as a member of UHCSA I am making a financial commitment to share in the risks and rewards of food production. I
recognize that there is no guarantee to the amount of vegetables and herbs I will receive.

I understand that I have a full responsibility to fulfill any work contribution that I agree to. I understand that I am required to work
specified hours each month during the growing season (April thru September). I will also cooperate with training in work procedures
that are safe and efficient, being willing to learn and be supervised.

I understand that it is my responsibility to pick up my share at Upland Hills CSA during the designated time period.
I understand that $100.00 of my share is non-refundable in the event I cancel my membership prior to the first distribution.
I understand that my 2009 membership fee is not refundable after May 1st.
I agree to the above terms of membership in Upland Hills CSA. I understand that the owners/members
of Upland Hills CSA reserve the right to terminate my membership if I don't abide by the terms as
stated.

1. _______________________________________ 2. ________________________________________
Signature Signature

_______________________________________ ________________________________________
Print Name Print Name

Date: ___________________________ Date: ________________________________

This membership share agreement shall be effective on the 1st day of May 2009 and shall expire on the 1st day of November