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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:_______________________________________________________________________________