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4. SR 06-06-2011
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4. SR 06-06-2011
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6/10/2011 2:54:27 PM
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Sherburne County Community Gardens <br />2009 Registration FormlWaiver Farm <br />Name: <br />Address: <br />Home Phone: <br />Email: <br />Number of Ptots which you are registering for: <br />Small Plot ($10.00 each) <br />Large Plot ($15.00 each) <br />Plot # <br />Plot # <br />WAIVER <br />Aft. Phone: <br />I, ,hereby release Sherburne County and the City of Elk <br />River, their elected officials, appointed officials and employees, and members of the <br />organizational committee of the Sherburne County Community Garden Project from any and al! <br />claims, demands, causes of action from any and all damages, including 6ufi not limited to <br />property damage and bodily injury incurred by me and members of my family resulting from any <br />and all activities associated with my participation in the Sherburne County Community Garden <br />Project. <br />(DATE) {SIGNATURE) <br />Sherburne County Extension Office -February 20!19 <br />
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