CSA Signup Form

Dear Share Holder,

We’re pleased and excited that you are considering joining our CSA program!

We have a few options for signup and payment this year. You can fill out the form online (below) or download a PDF of the form to drop in the mail. And to pay you may pay by check or by credit card. You may make your payment in full or if you prefer, you can make payments, as long as you have it paid in full by June 1st.

Once we’ve received your payment, we’ll send out your receipt and find out where you want to pick up your CSA box. Please remember to bring your box with you when you visit the farm or any of our markets. Without it, you won’t be able pick up your goodies!

Your CSA membership also entitles you and your family to attend our fall festival. We’ve got a lot of fun and exciting things planned this year.

Thank you for choosing to be a part of our farm family. We look forward to seeing you.

Sincerely,

Dave Patterson
Miller Farms

½ membership $400
Full membership $600

Member Info

Member's First Name: *

Member's Last Name: *

Member's Email: *

Member's Phone: *

Member's Street Address: *

Member's City: *

Member's State: *

Member's Zip Code: *

Payment Info

Payment Method: *

Check

Credit Card

Referred By:

Please enter the name of the person who referred you to our CSA program.

CSA Risk Disclaimer

As a CSA member I realize I am supporting Miller Farms by buying a share or half share of their 2012 produce, and that I am also sharing in the risks all farms experience each year.

I acknowledge I understand and agree that should a total or partial crop loss occur due to any act of God or criminal activity, that Miller Farms and/or it’s owners and assets will not be held responsible for such loss, and the shareholder will not seek repayment for the loss of his/her share; nor will the shareholder consider Miller Farms and it’s entities responsible for such losses. In the event of a partial loss, Miller Farms will do everything in its power to adjust the remaining portion of my share and assist me in getting the reasonable expected value of the remaining
crops/share.

Losses and perils include, but are not limited to the following:

Fire/Lightning
Water/Flood/Rain/Hail/Snow/Freeze/Frost/Drought
Wind Damage, to include Tornadoes and Microburst
Blight/Insect Damage/Bird or Animal Damage
Vandalism/Criminal Activity

Risk Acknowledgement: *

Yes, I have read and acknowledge I understand and agree to abide by the terms of the CSA Risk Disclaimer

Miller Farms

CSA Signup Form

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