2017 3rd-6th Grade Day Trip Registration
Please enter your information to enroll in the 2017 Day Trip. Please enroll your children by July 1st.
Adventure Grows Here
First Name
Your answer
Last Name
Your answer
Grade (2016-2017 School Year)
Your answer
Age
Your answer
Address
Your answer
City
Your answer
Zip
Your answer
Parents Name
Your answer
Home Phone
Your answer
Cell Phone
Your answer
Email Address
Your answer
Does your child have any allergies?
Please list any allergies.
Your answer
Club
Please Choose your club from the list below. If you are not a 4-H Member please choose the last selection "Monroe County Youth (Not a 4-H Member)".
Medical Information
We will also use the Medical Information from the 4-H Online Profile to care for your child. Please make sure you update no later than July 1st, as that will guide us in caring for your child in an emergency.
Payment
Please print the confirmation page and mail with payment to the address below. The price is $15 for each youth attending.
(If you are entering multiple youth, you may just print the final confirmation page.)
Please mail confirmation and payment to the Extension office as soon as possible.
Monroe County 4-H
14345 County Hwy. B, Room 1
Sparta, WI 54656
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms