LAS FLORES COMMUNITY GARDEN
APPLICATION FOR MEMBERSHIP

NAME:_____________________________________________________________ PLOT:______________

ADDRESS:_____________________________________________________________________________

CITY:________________________________________________________ ZIP CODE:________________

TELEPHONE #:______________________________ CELL #:____________________________________

EMAIL ADDRESS:_______________________________________________________________________

EMERGENCY CONTACT(Name/Phone):_____________________________________________________

GARDENING EXPERIENCE:______________________________________________________________

SPECIFIC GARDENING INTERESTS: _______________________________________________________

HOBBIES:_____________________________________________________________________________

CLUB MEMBERSHIPS/ACTIVITIES:_________________________________________________________

BY SIGNING THIS APPLICATION YOU UNDERSTAND AND AGREE:

1. THE GATE CODE IS NOT TO BE GIVEN TO ANYONE WITHOUT PERMISSION FROM THE BOARD.
2. NO ONE IS TO BE ON THE GARDEN PREMISES UNLESS THEY HAVE SIGNED A WAIVER.
3. THOSE LISTED ON WAIVERS ARE NOT GARDEN MEMBERS AND ARE NOT SHARING THE PLOT.
4. YOU HAVE READ, UNDERSTAND AND AGREE TO ABIDE BY LFCG’S RULES AND BYLAWS.
5. FAILURE TO MAINTAIN AND PLANT PLOT AS REQUIRED, COMPLETION OF WORK HOURS,  PAYMENT OF FINES, OR THE CORRECTION OF ISSUES WITHIN THE 3 WARNING TIME FRAME MAY RESULT IN MEMBERSHIP TERMINATION WITHOUT REFUND OF PLOT OR SECURITY FEES.

PRINT NAME:__________________________________________________________________________

SIGNATURE:_________________________________________________________ DATE:_____________

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OFFICIAL USE ONLY

RENTAL FEE:_______________ CHECK #:_______________ DATE:_______________

DEPOSIT FEE:______________ CASH:__________________DATE:_______________

TOTAL DUE:______________________

DATE RESIGNED:_______________ DEPOSIT REFUND DATE:___________________

NOTES:_______________________________________________________________________________