Regional Junior 4-H Camp - Whispering Cedars Camp, Genoa - June 1-3, 2022
The early bird registration and fee payment of $100 per camper is due by 5 pm CT, Friday, May 6, 2022. The camp registration fee after this date/time until 5 pm CT, May 12th is $125 per camper. Camp registration closes 5 pm, May 12th. Please pay your camp registration fee at your local Nebraska Extension Office. Campers must turn 9 to 12 years old during the current year to be eligible to attend camp.
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Email *
County of 4-H Enrollment or Residence *
What is your first name? *
What is your last name? *
What is your home address? *
What city/town? *
State *
Zip Code *
What is your phone number (Cell phone number preferred - ie. 402-741-2158)? *
Please provide an emergency contact phone number. *
Birthday (MM/DD/YYYY *
MM
/
DD
/
YYYY
Your Gender *
Do you have special diet or other assistance needs? Please indicate None or Other. If Other, please describe your needs. *
Name a Roommate Preference. You can name ONE roommate & your roommate must also list you as their single preference too, if you have one. List your ONE roommate under "Other." *
Have you completed the on-line 4-H Participant Permission and Health Form? *
Required
T-Shirt Size *
I will or have paid the following camp fee in our local Nebraska Extension Office - *
Thanks for registering for the 2022 Jr. 4-H Camping season. We're looking forward to seeing you on June 1st!
A copy of your responses will be emailed to the address you provided.
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