Winter & Spring 4-H Registration 2024

POLK COUNTY 2024 4-H Winter Registration
Personal and Demographic Information
Child's Name*

First NameLast Name
Child's Current Age and birthdate*
Child's Current Grade Level (as of the 2023/2024 school year)*
Gender of Child*
Parent or Guardian Name*

First NameLast Name
Relationship to Participant*
TIME-SAVING ANNOUNCEMENT! If you are registering more than one child, you only need to fill out the following address, and phone number fields ONCE. For all additional online registration forms for children in the same family, you may leave these fields blank. However, if you are only registering one child, PLEASE FILL OUT ALL FIELDS BELOW.
Address*

Street Address

City

Postal / Zip Code
Home Phone (if applicable)
Cell Phone (if applicable)
Best number to reach you for class changes, cancellations, or emergencies*
Parent Email*
example@example.com

This semester, we are offering six different programs to choose from. Registration is on a first-come/first-served basis. We recommend that you register your child as soon as possible to ensure his/her spot in your chosen programs.
I'm registering my child/teen for:
prevnext( X )
4-H Cloverbud ProgramYouth ages 5-8 will explore a variety of educational activities to introduce them to 4H
$10.00



Goat Breeding and Kidding4 week introduction to the breeding and kidding of Nigerian Dwarf goats. Ages 9-15
$ Free



Intro to the 4-H Electric ProgramIntroduction to electronics, soldering and wiring, Ages 10-15
$10.00



Intro to the 4-H Poultry ProgramLearn about starting and maintaining a backyard flock. Ages 8-15
$ Free



Total

$0.00
N.C. Cooperative Extension prohibits discrimination on the basis of race, color, national origin, age, sex (including pregnancy), disability, religion, sexual orientation, gender identity, genetic information, political affiliation, and veteran status.

Have questions before you click "Submit" to submit your registration below? Contact Polk County 4-H Agent Helen Blackwell by phone at 828-894-8218 or by email.
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POLK COUNTY 2024 4-H Winter Registration