Value Added Kitchen
Registration, Agreement and Emergency Contact
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Email *
Name *
Address *
Phone Number *
Emergency Contact Name & Phone Number *
It is important that Cooperative Extension has information regarding overall production in the Value Added Kitchen. Would you please list your approximate projections for this year?
What do you plan to produce in the kitchen?
Name of Product(s)          Units Expected          Value *
Will you be selling your product(s)? *
N.C. Cooperative Extension, Madison County Center, Madison County Government and NCDA will not be liable for any food-borne illness outbreak from any products produced in the kitchen by the User.  

All sold products must comply with any local, state, and/or federal rules and regulations. 

The VAK is a ‘use at your own risk’ facility. 

N.C. Cooperative Extension, Madison County Center is not responsible for product loss, personal property damage, or personal liability.  

If you decide to sell your product(s), you must contact NCDA to schedule an inspection (984-236-4820). 

I agree:
 *
I have read and agree to the Value Added Kitchen Policies and Fees. *
Signed: *
Date: *
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