2025 4-H Jr. Leader Lock-in
WHEN: Tuesday, December 30th-Wednesday, December 31st
TIME: 7:00 p.m.-7:00 a.m.
WHERE: Merrick County 4-H Building
         1784 Fairgrounds Rd, Central City
REGISTER: by Monday, December 22nd

For ALL teen 4-H members in Merrick & Hamilton Counties. Experience great friendships, learn leadership lessons and life skills, win the CHOPPED! Challenge and have fun! 

Sign in to Google to save your progress. Learn more
Email *
Teen's First Name *
Teen's Last Name *
Teen's Current Age (not 4-H age)
Clear selection
Teen's Phone # (text reminders)
Additional Phone #'s (text reminders)
Parent/Guardian Email (for reminders, if different from above)
Parent/Guardian Name *
Emergency Contact Phone # *
Any allergies or concerns staff should know about. *
Is this teen currently enrolled in 4-H? *
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Nebraska Extension.

Does this form look suspicious? Report

Google Forms