Send to:

Skipper Farms

3640 Dam Neck Rd.

Va. Beach, VA 23453

Name:__________________________________________________________________

Address:________________________________________________________________

Home Phone:_____________________________________________________________

Cell Phone:______________________________________________________________

E-Mail Address:__________________________________________________________

I would like to sign up for the following:

( ) Family Share $563.75

( ) Couple Share $377.71

We accept MasterCard, Visa, Discover, & American Express for your convenience.

I prefer to pick up my share each Friday between 12 p.m. and 6 p.m. at:

( ) Virginia Beach Farmers Market

( ) 2928 S. Battlefield Blvd., Hickory in Chesapeake

If for any reason a member is unable to pick up their weekly share, arrangements should be made by the member to have someone else pick up the share at your designated location. You should retain a copy of this agreement for your records.

Signature:_____________________________________________________________

Date:_________________________________________________________________

Thank you for choosing Skipper Farms for your CSA! If you have any additional questions call us at 757-368-0355