Print this out. Fill in the information, and sign it. Return it with the appropriate payment from the chart below in check or money order to:   Lewis Creek Farm, PO Box 123, Starksboro VT 05487.

Name _________________________________
Address_______________________________
City State Zip_____________________________
Telephone No.__________________________
Email: ________________________________

Number of people in household:
Adults________ Children_______

Share size (circle one) Standard or Small

Pickup Site: (circle one) Lewis Creek Farm         Middlebury         South Burlington

Farm Share Agreement
I understand that I am buying a share of the harvest at Lewis Creek Farm for the 2011 growing season, subject to availability and weather conditions. I understand that I am sharing the risks inherent to agriculture which include but are not limited to drought, flooding, hail and frost. In a normal year participants in the program will receive 20 weekly installments of vegetables. The vegetables available will be chosen by Lewis Creek Farm and not all vegetables listed or grown on the farm will necessarily be available through this program. I understand that each weeks share is seasonal and perishable and that it has no value that can be credited towards a future date should I miss a week for any reason.

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Signature of participant