Garden Registration Form Contact InformationName:Address:City:Zip:Phone:Email: GardenGarden: Brewster St., 3300 W. Brewster St., Appleton Covenant, 1601 S. Covenant Lane, Appleton Clearwater, 2111 Marathon Ave., Neenah Goodwill, 1800 Appleton Road, Menasha GV/Casaloma, 5304 W. Greenville Drive, Appleton Hope, 415 E. Hoover Ave., Appleton St. Therese, 213 E. Wisconsin Ave., Appleton UW-Fox Valley, 1478 Midway Road, Menasha Any Years in Program:Emergency ContactName:Relation:Phone:Civil Rights ComplianceFamily Ethnicity:Ages of Family Members:Females:Males:Donations:Community Garden (Plot $20/plot annually):Tilling ($20/plot annually):Additional Program Donation:TOTAL:Please Estimate (last season’s numbers)Number of people eating food grown on your plot(s):Number of people that garden on your plot(s):Annual revenue generated (if applicable): $Pounds of garden produce donated to pantries:Contact PreferencesContact Preferences: Email Phone Text Home Letter Sign me up for the: Growing Matters Newsletter: I would like translation services (language):OfficePlot Number(s):Paid in Full:Date: TM:VolunteeringCommunity Gardener: caring for water tanks flower beds compost bins etc. Build Crew: garden construction development projects Garden Leader: leads gardens committees projects Educator: teaches class(es) performs educational outreach Garden Mentor: assists new gardeners those looking for help List your other interest area(s):Volunteering is a core part of community gardening. Hours, that I can commit to roughly of service this season:I have read and understand the garden Ground Rules and agree to follow them as established. I acknowledge that failure to do so may result in separation from the program. I understand that my services are being offered on a voluntary basis without anticipation of financial compensation and I grant permission for my photo and the photos of my family to be used in any promotional material produced by Goodwill Grows. I will not hold Goodwill Grows, Goodwill NCW, or its partners liable for mishap or injury of any kind occurring during program participation or at any program site. Signature:Date: This iframe contains the logic required to handle Ajax powered Gravity Forms.