Community Roots Gardener Application

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Email *

Gardener Name: *

Gardening partner(s) name(s):

Gardener address:

Gardener phone:

Gardening Partner(s) phone:

Gardener email: *

Partner email:

I would like to utilize an wheel-chair accessible raised-bed.

Yes. I require a wheelchair for most/all of my mobility needs.

Yes. I have back issues and the additional height would be very helpful for me. I understand that people who use wheel-chairs will be given the priority, though.

No, thanks.

Clear selection

If you are a new gardener, would you like an experienced gardener to help you?

Yes

Clear selection

If you are an experienced gardener, would you like to help a new gardener?

Yes

Clear selection

Please check any extra activities you would be interested in:

Assisting with Farm to School garden beds

Mowing

Composting

Watering for gardeners who are away

Tool/supply maintenance

Garden photography

Gardening education

Fundraising

Other ____________________

None

Photo permission: From time to time, gardeners, garden leaders and the media will take photos of the garden and gardeners. Please tell us if you do not give your permission for your photo to be published. (If you do not give permission, please let photographers know if you encounter them at the garden.) *

I do NOT give my permission for my photo to be published

my photo may be published

Maybe, I will communicate with photographers in the garden on a case by case basis

All gardeners are required to share their phone number and email address with garden leaders. In addition, a gardener phone and email list is shared with all gardeners. Please tell us here if you do not give your permission to share your email and phone number with all gardeners. *

I do NOT want my information shared with other gardeners

My information may be included in the shared directory

By printing my name below, I agree that I have read and understand the Gardener Guidelines and plan to abide by all of the garden rules. I understand that neither the Community Roots nor the owners of the land are responsible for my actions. I therefore agree to hold harmless Community Roots and owners of the land for any liability, damage, loss or claim that occurs in connection with the use of the garden by me or my guests *

Date

YYYY

Send me a copy of my responses.

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