Registration

Parent/Guardian's First Name *

First

Parent/Guardian's Last Name *

Last

Email Address *

Enter Email

Confirm Email Address *

Confirm Email

Phone

Address

City

State/Province

Zip/Postal

Country

1st Child *

First

1st Child's Last Name *

Last

1st Child's Age

2nd Child

First

2nd Child's Last Name

Last

2nd Child's Age

3rd Child

First

3rd Child's Last Name

Last

3rd Child's Age

Gardening Experience

Describe your child’s/children’s experience and/or interest in gardening.

Do you have a water source and a sunny space for a 3’ x 5’ raised garden bed?

The space you select should have full sun from 10 AM to 4 PM. A mentor will help build your raised bed and materials will be provided.

Will your child(ren) and an adult be able to attend monthly meetings at Erickson Fields?

Meetings will be held from 4 PM to 6 PM on the first Wednesday of each month, June through October.

Does your child(ren) have special needs such as physical limitations or allergies that we should know about?

Select the top 6 veggies that you and your child(ren) want to grow!

Do you need a scholarship?

No, I can pay the $75 program fee

Yes, a full scholarship

Yes, a partial scholarship of this amount:Yes, a partial scholarship of this amount:

Scholarships are available on a sliding scale. We want this program to be affordable for all who want to participate.

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