4-H Teen Leadership Winter Camp 2022 Registration
Friday, January 28th from 7:00 p.m. - Saturday, 29th at 7:00 p.m., 2022 at the Lions Camp • Rosholt, WI
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First Name *
Last Name *
Age *
Gender *
Current Grade *
Which Wisconsin county do you live in (or participate in 4-H with)? *
Home address (for mailing purposes) *
E-mail address *
Parent/Guardian name *
An EEO/AA employer, University of Wisconsin-Madison Division of Extension provides equal opportunities in employment and programming, including Title VI, Title IX, the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act requirements.
Do you have any dietary or special physical or medical needs our staff should know about ahead of time? If so, please click "yes", and someone will contact you for more information. Things that would be appropriate to share would be food or other allergies, or accommodations for typical programming so that our staff is as prepared as possible to ensure your youth will have a high-quality experience.   *
Yes, I realize that in order to participate in 4-H programming, I will need to bring along the paper copy of the health form and hold-harmless form. *
I realize that the 4-H Teen Leadership Winter Camp will be held at Lions Camp in Rosholt. Transportation to and from is the responsibility of the participant's parent or guardian to arrange. *
I realize the costs associated with camp must be paid in a timely fashion. I will make the appropriate payments to my local 4-H county educator. *
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