2025-2026 Jackson County 4-H Enrollment Form - Specialty Clubs - After-School Events - Livestock Show Team
Thank you for joining Jackson County 4-H! We are looking forward to a great program year.
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4-Her's Last Name *
4-Her's First Name *
4-Her's Middle Initial *
4-Her's Address *
4-Her's City *
4-Her's Zip Code *
4-Her's School *
4-Her's T-Shirt Size *
4-Her's Date of Birth *
Datum
4-Her's Grade *
4-Her's Racial Classification (check all that apply) *
Pflichtfrage
4-Her's Residence *
4-Her's Ethnicity
Auswahl löschen
Gender *
4-Her's Cell Phone (if applicable)
4-Her's email (if applicable)
Parent's Last Name *
Parent's First Name *
Parent's Cell Phone *
Parent's Email *
Additional Parent's Last Name
Additional Parent's First Name
Additional Parent's Cell Phone
Additional Parent's Email
Please indicate which clubs/activities you will be participating  (or would like more information about) in this year. Check all that apply *
Pflichtfrage
Are there any health concerns or special needs you'd like the extension office to be aware of?
Senden
Alle Eingaben löschen
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