Application and Advisement of Risk

Beacon Falls Community Garden

2016 Application and Waiver

Mail payment, completed application, signed waiver and regulations to Beacon Falls Community Garden, 140 Burton Rd. Beacon Falls, CT 06403. The yearly fee for a 10’x20’ plot is $30.00. Make checks payable to Beacon Falls Community Garden. All fees are non-refundable.

Gardeners are required to maintain their plots throughout the season and to be responsible for a garden task throughout the year. Plots are subject to availability and assigned by the garden administrator.

Name: ____________________________________________________________________
(please print clearly)
Mailing Address: ____________________________________________________________

Phone: ________________ Email Address: ______________________________________


Best way to be contacted:_____________    Will you need your plot tilled this year?_______

Advisement of Risk

Please read this form carefully and be aware that in registering for a plot at the Beacon Falls Community Garden you are advised of the risks which you may experience as a result of participating. The Beacon Falls Community Garden is an activity in which, despite preparation, instruction, medical advice, conditioning and equipment, there is still a risk of injuries as the following. This list is by no means complete or exclusive, but includes:  Muscle strain and other muscle injuries, foot problems, falls, heat strokes or heat exhaustion, insect bites.

I further agree to indemnify, hold harmless and defend the Town of Beacon Falls and the Beacon Falls Community Garden, its officers, agents, employees and authorized volunteers from any and all claims by me or other parties resulting from injuries, damages, and losses caused by me arising out of, connected with, or in any way associated with the activities of the Garden.

I have read and fully understand the above. I understand this agreement shall not be modified orally.

Signed __________________________________________ Date_____________________

I have read the garden regulations and agree to comply with them. I understand that failure to comply with regulations will result in loss of gardening privileges and reassignment of my plot without refund of fees, and denial of application for the following year, as determined by the Beacon Falls Community Garden administrator.

Signed __________________________________________ Date_____________________

Contact Shannon Rodorigo at [email protected] for availability of plots or questions.