2024 Farm Fresh Box Registration Form
If you have any questions please email us at farmbox@simpsonfamilyfarms.ca
Name
*
First Name
Last Name
Number
*
-
Area Code
Phone Number
E-mail
*
Farm Pick Up
*
Farm Pick Up Only: Fridays 2pm to 5:00pm
Address
*
Street Address
Street Address Line 2
City
Province
Postal
Box Option:
*
ENTIRE SEASON
My Products
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Family Size Farm Box
$
31.00
CAD
Feeds 4- 6: Family size variety of produce (selection is depending on the week and availability)
Farm Fresh Eggs
$
7.00
CAD
12 (Dozen) Farm Fresh Brown Eggs - sourced from neighboring farm
Quantity
1
2
3
4
5
6
7
8
9
10
Farm Fresh Bread
$
8.00
CAD
Fresh baked local bread. No preservatives .
Quantity
0
1
2
Type of bread
Multi-Grain
Potato
Sour Dough
Delivery Fee
$
3.00
CAD
If you require delivery, please check off
Total
$
0.00
CAD
Credit Card
Payment Options for season. Please note to secure your spot you must send a deposit of one full box payment by paying with your credit card, the rest of season is paid by any of the following options:
*
E-transfer ( Send to info@simpsonfamilyfarms.ca)
Cash
Credit Card
Signature: I agree to the term that the deposit submited today is used toward the final week 14 box of the season, in the event that I need to cancel, I will lose the deposit paid today.
Submit Order
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