Individual

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Please fill out form below

First Name*

Last name*

Pronouns

They/Them

He/Him

She/Her

Other

Your email*

Phone number*

Best way to contact*

Phone call

Text

Email

Emergancy contact*

Emergancy contact phone*

How are you getting to the garden?*

What agency do you work with?*

Support Person 1*

Support person 1 phone*

Support person 2 (optional)

Support person 2 phone number (optional)

Do you need a garden box with wheel chair access?*

Yes

No

Any other needs?

Do you give Aspire Together the permissin to post your picture on Facebook, Instagram, or advertisements for the garden? (We take the privacy of our members very seriously and a no answer will be strictly enforced)*

Yes

No

Questions or concerns?

By typing my name below I have agreed to the following (check the box once you read and understand):

I will do my best to take care of my garden box

I will respect and show kindness to my fellow gardeners

I will try my best to check in via text message and stamp passport each time I arrive to the garden

I will respect nature and the garden by picking up garbage, pulling weeds, and taking care of the space

I will communicate with leadership if I am unable to tend to my gardern or need to give my plot to someone else

I will try my best to attend the garden classes and participate in the program activities

I understand that the church is letting us use their property and I will make safe choices while on the property. (Please do not use the playground, Aspire Together is not liable for playground related injuries)

Type your name here if you agree*

Help

Community Resources for Individuals with Developmental & Intellectual Disabilities

Contact

Connect

Aspiretogethernonprofit.com

503-451-0675

Mailing Address:

5862 SE Lloyd St Milwaukie OR 97222

Garden Location:

15303 SE Webster Rd Milwaukie OR 97222