CSA Sign-Up Form

Please print this page, fill out the form, make your check payable to Kent Family Growers and mail both to:

Kent Family Growers
1301 CR 31
Lisbon, NY 13658

Please feel free to call 315.212.7502, or e-mail us at kentfamilygrowers@hotmail.com with any questions or special requests regarding payment. A share subsidy may be available to you via  Gardenshare. Contact them by phone at 315.261.8054. Staff of Canton Potsdam Hospital qualify for a cost-share program funded by the hospital. Subtract $100 from your share price and indicate on this form that you are employed by CPH.

_____ One Full Share @ $600 starting mid-June through early-November
_____ One Basic Share @ $400 starting mid-June through early-November

_____ One Flower Share @$100, 10 weeks, early-July to mid-September

_____ One Winter Share @$450, mid-November - mid-March

Name(s):

Address:

Phone:

E-mail:

Pick-up locations (indicate one):

Friday  -  CFC in Madrid  -  Canton Farmers Market  -  Frazer Computing, Inc. Canton

Tuesday  -  Potsdam, on Cottage Street

                  We will contact you with pick-up location details once you have signed up

    Veggies!