Quail Hollow Farm Full-Diet Share Agreement 2017

As the  new year is getting closer and there is much to do to prepare, we will require ½ down payment for the year to reserve your spot. The remainder of the payment will be due by January 1st. This is non-refundable but transferable. Payment options are available. All members of the household must be included.

Name of each family member:

__________________________________________________________________________________

 Address:___________________________________________________________________________

 Phone:_____________________________Email:____________________________________________

Please fill out the following form including every member of your household.

Share Description    Name of Shareholder   Unit Price  x    #Weeks             Total Amount

1st Adult Share         _______________________  $90/week                 52            $___________

2nd Adult Share        _______________________  $80/week                 52            $___________

3rd & up Adult Share_______________________  $75/week               52            $___________

1st Child                  ­­­­­­­­­­­­­­­­_______________________  Age x 4/week             52            $___________

2nd Child                 ­­­­­­­­­­­­­­­­_______________________  Age x 4/week             52            $___________

3rd Child                 ­­­­­­­­­­­­­­­­_______________________  Age x 4/week             52            $___________

4th Child                 ­­­­­­­­­­­­­­­­_______________________  Age x 4/week             52            $___________

Child under 3 years   _______________________           Free               52            $0

Child under 3 years   _______________________           Free               52            $0

                                                                 2017 Household Share Total:   $___________


Disclaimer I understand that farming is unpredictable. In joining Quail Hollow Farm, I understand that there will be variations in the quantity and the quality of food that I receive, depending on weather and other factors. I hold harmless Quail Hollow Farm for injuries that may occur to my family, me or anyone in my party while we are on Quail Hollow Farm, and for any illness or injury contracted from being on the farm or eating food from the farm. I understand that the dairy is not pasteurized and that these and all foods may carry certain health risks.

 All adult signatures:_________________________________________________________

Date signed: _______________________________________________________________

Member Release Form: Acknowledgment of Risks and  Hazards Liability Release (or) Release, Waiver of Liability, Assumption of Risk, & Covenant Not To Sue. I understand that all food produced on the farm may have inherent risks and dangers as well as risks that may be individual in nature, and may put me and members of my family in my household at risk of serious foodborne illness, disease, infirmity or even death. I agree to release, forever discharge, indemnify, defend and hold harmless Quail Hollow Farm, its owners, officers, agents, and employees from all liability for negligence and any and all losses, damages, costs and attorney’s fees resulting from any and all claims or suits for personal injuries, death and/or property damage of any kind while on the farm or after leaving the premises. I have read and understand the above paragraphs. I voluntarily enter into this agreement on behalf of myself and other family members listed below.

All adult signatures:_________________________________________________________

Date signed: _______________________________________________________________

Please write in your family members names below when you and your family have all read and understand this release form.

Please send signed Share Agreement & payment to:

Quail Hollow Farm, P.O. Box 688, Overton, NV 89040

(We can take credit cards but must include a 3% service charge.)

For questions, contact us via email @ quailhollowfarm@mvdsl.com or call 702-397-2021.

We are super excited to be your farmers for this year!!!