Registration Form

Parents Name

Address

City

State

Zip

County

Phone Number

Email

Childs Name

Age (as of January 1st)

Childs Name

Age (as of January 1st)

Childs Name

Age (as of January 1st)

Childs Name

Age (as of January 1st)

Childs Name

Age (as of January 1st)

Childs Name

Age (as of January 1st)

Is anyone in your family a current 4H member? Is anyone in your family a current 4H member? Yes No

NOTICE: NOTICE: Parents are responsible for their children. Millar Angus is not responsible for accidents.

Parent or Guardian Electronic Signature: