2024 Poultry Registration Form

Email below will be the email the registration receipt will be sent to

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Email *
Please fill out one form for EACH poultry project you are bringing
Example, if you are bringing one duck and a market cornish game hens, fill out one form for the duck and one form for the market cornish game hens.
Species
*
Required
Member's Last Name *
Member's First Name *
4-H Club Name
*
Class *
Special Considerations
Education One
*
Required
Education Two
*
Required
Work Bee
*
Required
4-Hers Date of Birth
*
MM
/
DD
/
YYYY
4-H Age (as of 01/01/2024)
*
4-Hers Street Address
*
4-Hers City
*
4-Hers Zip Code
*
Primary E-Mail Address
*
Secondary E-Mail Address
Parent(s)/Guardian(s) Names (How you want it printed in the auction book)
*
Primary Parent Phone Number
*
Secondary Parent Phone Number
Project Breed (if unknown, enter N/A)
Project Date of Hatch (if unknown, enter 00/00/0000)
MM
/
DD
/
YYYY
Is the poultry housed at the above address?
*
If no, please provide the contact name, phone number, and address for the location that the poultry project is housed at?
CLOVERBUD and SHOW ONLY: Are you showing someone else's poultry project?
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If yes, please provide the name of the 4-H project owner:
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