Spoutwood Farm CSA 2013 Commitment Form

Name (primary shareholder):_______________________________________Date_____________

Name (co-shareholders):_____________________________________________________________

Children (include ages): _____________________________________________________________

Address:__________________________________________________________________________

Phone(s):___________________________________Email___________________________________

How did you find out about Spoutwood Farm CSA?__________________________________________




Share Size and Number (Check all that apply, include # if more than one)

__ Large Share(s) (intended for 3-4 people)

__ Medium Share(s) (intended for 1-2 people) (roughly 60% of a large share)

Pick-up Locations

__ At Spoutwood Farm in Glen Rock, PA

__ In Hanover, PA

__ At Whole Life Boost Natural Foods in south York, PA

__YMCA Graham Aquatic Center, 542 N. Newberry, York, PA

__ In Cockeysville, MD

__ In Baltimore (Roland Park)

__ I am interested in the Group Membership option (please call for info)

__ I am interested in being considered for a Labor Support position (limited availability), in which I will contribute 8 hours labor in exchange for a reduction in my share cost.

__ I would like to be considered for a Working Share, in which I will exchange my labor for a share (70 hours/medium share,100/large;  call for info and confirmation)

Payment Amounts and Schedule

$_______ Cost of full share ($695 per Large Sh., $475 per Medium Sh)


$_______ =TOTAL owed for the year.  Billing Option________(you will be billed later)

$_______ =Amount paid now ($100 deposit, or full payment.  Paying more now helps us greatly)

$_______ =Amount I owe  (TOTAL minus amount paid)

Shareholder Pledge I/we pledge to receive our proportionate share of the total CSA harvest as a weekly delivery of fresh local organic produce.  I/we will share the bounty of large harvests and the limits of reduced harvests.  I/we pledge to provide our CSA support.  I/we pledge to care for the local community, to care for the land that we use for our sustenance, and to care for the web of life on Earth on which we all depend.

Signed:____________________________________________ Date:_________

Please print using the print icon above, complete and mail to: Spoutwood Farm CSA, 4255 Pierceville Rd., Glen Rock, PA, 17327

Please call if you have any questions: 717-235-9272

or E-mail us at: This e-mail address is being protected from spambots. You need JavaScript enabled to view it