CSA Registration Form

General Information

Name:

Email:

(one only please!)

Address:

City:

Province:

Postal Code:

Phone:

Household size:

members

Pick-Up Location

Please choose to join 1 of 2 membership groups:

FULL! Mount Hope Pick-up Group:
Tuesdays, 3:45-6:15, 21 Guelph St., Kitchener
Farm Pick-up Group:
Fridays 4:00-5:30, 1560 Carmel-Koch Rd, St. Agatha

If you'd prefer the Mount Hope Pick-up, please indicate in the comments section in case a share opens up.

Share Size

I would like a:

Small share for $375
Regular share for $650
Large share for $925

A small share feeds a couple or an individual with a large veggie appetite.
A regular share feeds a family of 4 or veggie-crazy couple.
A large share feeds a larger family or veggie-loving small family.

	Small	Regular	Large
Price	$375/season	$650/season	$925/season
Instalment Option	$100 deposit at sign-up $125 by April 1 $150 by June 1	$100 deposit at sign-up $275 by April 1 $275 by June 1	$100 deposit at sign-up $400 by April 1 $425 by June 1

CSAs incur most of their costs before the season even begins. One of the reason CSAs were developed was to help with this problem by offsetting costs at the beginning of the season when funds are needed most. Although an instalment option is provided to break up your costs if necessary, please consider paying the full amount as early as possible. All those who pay for the full season by March 15 will receive a bonus quart of strawberries as a thank you gift. Your support is greatly appreciated!

Please make cheques payable to Fertile Ground CSA. Post-dated cheques are the best way to pay if you choose the instalment option. Please note: $25 charge for NSF cheques.

Please mail cheques to:
Fertile Ground CSA
2-21 Guelph St. Kitchener, ON N2H 5W5

Other Local & Organic Food Items

Please check which, if any, of the following local, organic products you would be interested in purchasing at the CSA pick-up. Some items would require pre-ordering. This isn’t a promise but will help us plan appropriate partnerships.

Regularly	Occasionally	Item
		Bread
		Free range eggs
		Cheese
		Chicken
		Beef
		Lamb
		Pork
		Goose or duck
		Turkey
		Honey
		Maple syrup
		Apple cider
		Local fruit
		Organic fruit

Correspondence

We send out most of our news and updates such as scheduling changes, bulk order items or other announcements by email. In addition, we will be putting together a bi-weekly newsletter with farm news, recipes, weekly crop lists and other tidbits. (The newsletter will also be posted on the website.) You will be included in the weekly newsletter mail-out unless you opt out below:

Please don’t include my name in the weekly newsletter email list
Please don’t add my name to Little City Farm’s email list
I don’t use email & would appreciate another method of correspondence

Final Bits

Comments or questions:
(including other emails you'd like to add)

I have read & agree to the Membership Agreement on the CSA Information page.

Please note that your registration won't be official until your deposit is received. If you do not see the confirmation page after signing up or do not receive a confirmation email, please turn on JavaScript or email us.