GROW WITH US Registration –
Please complete this form to help us understand your interests, needs, and preferences for joining GROW WITH US
Basic Information
Tell us about yourself.
Full Name
*
First Name
Last Name
Preferred Name (if different)
Age
*
Best way to contact you (phone, email, caregiver, etc.)
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Please add any additional contact information.
Gardening Interests
Share your gardening experience and interests.
What interests you most about joining the gardening group?
Have you done any gardening before? If yes, what kind?
What types of plants are you most excited to work with?
Flowers
Vegetables
Herbs
Indoor plants
Not sure yet
Abilities & Preferences
Let us know what you enjoy and any preferences you have.
What gardening activities do you enjoy or would like to try?
Planting
Watering
Harvesting
Weeding
Painting pots / creative activities
Learning about plants
Are there any activities you prefer not to do?
Support & Accessibility
Help us provide the support you need.
Do you need any accommodations or support to fully participate?
*
Do you use any mobility aids?
*
Wheelchair
Walker
Cane
None
Other
Are there any sensory sensitivities we should be aware of?
*
Health & Safety
Let us know about any health or safety considerations.
Are there any medical considerations we should know to keep you safe?
*
Do you have any allergies we should be aware of?
*
Bees
Plants
Latex
Other
Communication & Support Team
Tell us how we can best communicate and support you. Participants cannot be left alone unless prior agreements have been made.
How do you prefer to receive instructions?
*
Verbal
Visual
Hands-on demonstration
Written
Will you be attending with a support person?
*
Yes
No
If yes, name and role:
*
Availability
Let us know when you would like to participate.
What days and times work best for you?
*
How often would you like to participate?
*
Weekly
Bi-weekly
Monthly
Additional Information
Anything else you'd like us to know?
Is there anything else you would like us to know to support you better?
Submit Application
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