CSA Registration Form
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Our CSA is sold out for the
2005 summer season.
To get on our mailing list for future CSA sign-ups, please e-mail us at:
Give us a call during business hours at our
High Desert Foods office 970-882-2116,
to sign-up using a credit card.
Or simply print and mail the form below with your check or credit card information.
SOLD OUT Large Share $550
SOLD OUT Medium Share $400
Share the Bounty: CSA is about sharing food, community and bounty. We will make CSA memberships available at a reduced cost to lower income households in the community. If you, your business, or organization would like to help pay for one of these households, please indicate so below:
I am interested in contributing to Share the Bounty. Here is my contribution $ ______________.
Total amount enclosed $________
Name ____________________________________________
Address _________________________________________
Ciy _________________________ State ____________
Zip _________________________
Phone ___________________________________________
E-mail ____________________________________________
Method of Payment:
____ Check
____ Credit Card
Credit Card # ______________________________________
Expiration _______________
Pick-Up Location (Please choose 1):
_____ 1st National Bank of Durango (259 W. 9th St.,
Durango, CO)
_____ High Desert Foods/ Kiva Orchard (18390 W. Hwy. 145, Dolores, CO)
Membership Pledge:
Membership Pledge: In becoming a member of the Kiva Orchard CSA, I understand that I am making a financial commitment for the 2005 season. I recognize that due to the inherent risks of farming there are no guarantees on the exact amount of produce I will receive, but I am willing to share the risks and reap the benefits along with the farmers. I understand that no refunds for CSA shares will be granted during the season. It is my responsibility to pick up my share at my pick-up site during the designated time period, or to send someone in my absence.
Signature ________________________________________
Send to:
Kiva Orchard CSA
P.O Box 2941
Durango, CO 81302
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