Community Garden Application

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Community Garden Waiver and Acknowledgement

I, the undersigned, attest that I have read and understand the Prairie Village Community Gardens Regulations and Subscription Agreement. I further understand that the City of Prairie Village and Global Montessori School are not and shall not be responsible or liable for any illness or injury to person, or loss of, or damage to, property. As the Subscriber, and the undersigned, I hereby forever release and hold harmless Global Montessori School and the City of Prairie Village, their respective employees, agents and representatives, from any and all claims of any kind that I, or my respective heirs, executors, administrators or assigns may have, or claim to have, resulting from the participation in the Prairie Village Community Gardens. Also, the Subscriber, and the undersigned, authorizes the Prairie Village Community Gardens to use at its discretion any photographs or video taken of the Subscriber while participating in the Program and waive any and all claims that the Subscribers or their respective heirs, executors, administrators or assigns may have or claim to have resulting from such photograph(s) or video(s).

I hereby agree to comply with the attached Prairie Village Community Garden Regulations and Agreement. I understand if I fail to do so I may lose my garden plot, plot fee and garden privileges.

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I am a...
I am a...
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Name(s)
 *
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Street Address
 *
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Zip Code
 *
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Phone
 *
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E-Mail (used for all communication)
 *
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Location of Choice
Location of Choice
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Preferred Plot Size

Preferred Plot Size
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Renewing Subscribers: Please list 2017 location and plot number
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Renewing Subscribers: Do you want to change plots? (You will be contacted before the lottery for reassignment preference)
Renewing Subscribers: Do you want to change plots? (You will be contacted before the lottery for reassignment preference)

Renewing subscribers must remit payment to City Hall:

Attn: Community Garden
7700 Mission Road
Prairie Village, KS 66208

All subscribers must attend an informational meeting to be scheduled in early 2018. Available plots will be assigned by lottery following the meeting.


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