Gwinnett County Master Gardeners Association

Please complete the application below. This form will be emailed to Diane Krish. If you prefer to pay by cash or check, you will need to do so at a meeting or email Diane at krishdiane01@gmail.com to receive a blank form.

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Member Information

Member Name *

First

Last

Check one of the following:

• I am renewing membership.
• I am joining as a new member.

If you are a Master Gardener, please enter your class year *

• Check if you do NOT want your information shown in the Directory.

Phone *

Email: *

Address *

Address Line 1

City

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Zip Code

your Credit Name

Liability and Release Form *

• I realize that when engaged in Gwinnett County Master Gardeners Association (GCMGA) activities, that serious physical injury and personal property damage may accidentally occur. I further realize that there is always the possibility of having an allergic reaction to or being poisoned by handling or ingesting plants and that adverse reactions may result in mild or fatal illness. Knowing the risks, I agree to assume the risks and agree to release, hold harmless, and to indemnify GCMGA and any officer or member thereof, from any and all legal responsibility for injuries or accidents incurred by myself or my family during or as a result of any and all GCMGA activity, field trip, excursions, meeting or dining, sponsored by the Association.

Credit Card *

Card

Name on Card

Confirmation

• Confirm Membership – $20.00

Submit

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