Renaissance Farms CSA 2009
Application/Agreement Form

Please print, sign, and return to:

Renaissance Farms CSA ~ 110 Partridge Hill Road ~ Charlton, MA 01507

I, ______________________________________, have read both the "CSA Agreement Terms" and "CSA Introduction" in their entirety, and do unconditionally agree to the "CSA Agreement Terms". I further understand that upon my written request I will be entitled to a refund for my subscription fee minus 10% administrative cost until 1 April 2009, after which time no refunds will be given. After 1 April I understand that I am responsible for the re-sale of my share(s) if I am unable or unwilling to participate in CSA. I agree that I will give proper notice of such a sale. I agree that I am solely liable for my actions and the actions of my dependants or companions while entered upon lands or market booths managed by Renaissance Farms/Brian and Nissa Gadbois. Furthermore, I unconditionally do hold harmless Brian and Nissa Gadbois, their family, employees and assigns for any and all accidental loss of any type that may occur while I am a guest on farm or at market. While on farm I unconditionally agree to follow all directions, rules and requirements as explained by Brian and Nissa Gadbois and their employees or assigns. I understand that I will be expected to leave the premises promptly if asked to do so and agree to this in advance. My signature below attests to my voluntary agreement to the foregoing in its entirety.
Signature: ________________________________ Date: _______________________

Renaissance Farms CSA strongly recommends that new members take the time to call and ask any questions you may have. CSA is not for everyone and we want to provide you with sufficient information to make an informed decision. Nissa's office day is Wednesday and may be reached at the telephone number above.

Please give us your complete contact information. [Indicate changes only for renewing members]
Name__________________________________________________________________

Mailing Address:__________________________________________________________
County:_________________________________________________________________
Telephone:_______________________________ Fax:_______________________________
Cell Phone:_______________________________ e-Mail_____________________________

Share preference (please indicate the quantity of each share):

Full ($1000) ____

Half ($500) ____

Individual ($250) ____

Goat ($520, plus $25 bottle deposit per share)____ **

Cow($625, plus $25 bottle deposit per share)____ **

**Milk-only shareholders are not required to participate in farm chores

Pick-up day, circle one:

Wednesday

Thursday

Friday

Saturday

Please print and fill out the "Agreement" [this form] and submit with your payment to complete your application

Check #:______________________________

CC#:_________________________________ Exp:____________ Sec. Code:_____

Signature:_____________________________________________________________

If you would like to be considered for work-share, please indicate portion of share to be worked/paid. __________/__________

PLEASE BE SURE TO VIEW, PRINT, SIGN AND RETURN A COPY OF OUR TERMS ALONG WITH YOUR PAYMENT TO:

Renaissance Farms ~ 110 Paartridge Hill Road ~ Charlton ~ MA ~ 01507