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2. First Name
3. Last Name
5. Address
7. City
8. State
9. Zip Code
11. Phone Number
12. Email Address

14. Please select your box of choice and provide proof of low income, senior status or ADA needs if applicable. Plot rates are per year and non-refundable. Full payment is due with signed agreement. After April 15th, gardeners may rent an additional bed or box, based on availability.

16. Select one:

    1. Raised Box Standard $17 each
    2. Raised Box Low Income $14 each
    3. ADA Raised Box $5 each
    4. Gate Key $10 each
18. Community Garden Agreement

    I received and understand the City of Washougal’s Community Garden Rules, Garden Manual, and Participant Waiver and Release forms for the current year’s gardening season. I agree to abide by these rules. Furthermore, I acknowledge that I am responsible for my own actions. I therefore agree to hold harmless the City of Washougal, its officers, directors, employees, and volunteers for any liability, damage, loss or claim that occurs in the connection with use of the garden by me or any of my guests. I understand that: 
    • My plot fee is nonrefundable. 
    • If I fail to pay my plot fee by the due date, I am forfeiting my plot, and my plot will be assigned to another gardener. 
    • If I fail to adhere to the hours of operation or any of the garden rules, I will forfeit my plot and future gardening privileges. 
    • If I fail to attend the mandatory meeting and participate in the mandatory cleanup session, I will forfeit my future gardening privileges.

20. Electronic Signature
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22. 1. Receive an email copy of this form.
23. Email address

    This field is not part of the form submission.

24. Submit

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