PARALAND 2015 CSA SUMMER SEASON SIGNUP FORM First Name: Last Name: Account #: Address: City: Postal Code: Email Address: Referred By: Preferred Box: Summer Weekly @ 20 Weeks Summer Bi-Weekly Egg Option: Weekly @ 20 Weeks Bi-Weekly Early Subscription 20 Special Price weeks @ 10% OFF Small $400 Medium $600 Large $800 Small $200 Medium $300 Large $400 1/2 Dozen Large Size $50 Full Dozen Large Size $100 1/2 Dozen Large Size $25 Full Dozen Large Size $50 Small $360/ Bi-$180 Medium $540/ Bi-$270 Large $720/ Bi-$360 Box Deposit:: $10 Special Requirements: Allergy Notice: Total: We accept payment by check. Please make your check payable to “Paraland Organic Farm” and mail it with this form duly completed to 2653 Chemin du Fief, Vaudreuil-Dorion, QC, J7V 0K4. Or scan the form to [email protected]. CONDITIONS - CSA BASKETS I wish to become a partner in the Paraland Organic Farm. I understand that I will receive my choice of 10 or 20 weeks of organically grown vegetables picked from Paraland Organic Farm. I understand that I will reap the benefits of the harvest season: fresh vegetables available as they mature, and sold at a fair price. I also accept to share the risks that are part of the farming business – inclement weather, pestilence and disease are factors that may affect the quantity and quality of the harvest, and may result in some vegetables not being supplied. However, I am assured that I will receive my fair share of the total vegetables produced by the farm. Signature: _________________________ Date: __________________________