Youth 4-H Fishing Tournament and Skills Session Registration for Non-4-H Members

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Youth 4-H Fishing Tournament and Skills Session Registration for Non-4-H Members - Check Payment

Fill out this form for EACH individual youth participant in your household or participating organization.

DID YOU KNOW? You can join 4-H for free, which means you will be able to participate in this program FOR FREE! Click on the link below to join 4-H:

Join 4-H for free: https://oneida.extension.wisc.edu/4h/about-4-h/. Then you can register as a 4-Her member here: https://docs.google.com/forms/d/e/1FAIpQLSe906l0_JskHkiYIkeXC9e95gDtdOfw3gl6Xz9wN7iqwVqZkg/viewform

No thank you - I want to register my child for this program as a non-4-Her and pay $10 to participate.

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Youth Participant First and Last Name *

Preferred Email Address where information will be sent: *

Phone Number: *

Mailing address where information can be sent: *

Participant's Grade Level as of Sept. 14, 2020: *

One year past high school

Youth Participant Race *

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

Two or More Races

Prefer Not to Indicate

Other:

Required

Youth Participant Ethnicity *

Hispanic or Latino

Not Hispanic or Latino

Prefer Not to Indicate

Other:

Required

Do you require an accommodation to participate in this activity?

Yes

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How did you hear about this activity? *

School

Library

Newspaper

Radio

Facebook

Friend

Other:

I will send a check for $10/youth participant by Oct. 2 2020, made out to UW-Extension Oneida County, and sent to Oneida County 4-H, 5364 College Dr., PO Box 518, Rhinelander, WI 54501, or my registration will be moved to a wait list, with no guarantee of participation. *

YES. I AGREE.

I understand that wearing a PFD is recommended when fishing from shore or from a dock with railings or in water that is no deeper than ankle deep. I understand that wearing a PFD is required when fishing in water that is deeper than ankle deep or from a boat or from a dock with no railings. *

Yes. I have read this and I understand it.

I need more information about this.

As the parent or caregiver of the participant who is being registered for the 2020 Oneida County 4-H Youth Fishing Skills Sessions and Fishing Tournament, myself, my heirs, personal representatives or assigns, agree to defend, hold harmless, indemnify and release the Board of Regents of the University of Wisconsin System, the University of Wisconsin-Madison, Division of Extension Oneida County, and their officers, employees, agents, and volunteers, from and against any and all claims, demands, actions, or causes of action of any sort on account of damage to personal property, or personal injury, or death which may result from my participation in the above-listed program. This release includes claims based on the negligence of the Board of Regents of the University of Wisconsin System, the University of Wisconsin-Madison Division of Extension Oneida County and their officers, employees, agents, and volunteers, but expressly does not include claims based on their intentional misconduct or gross negligence. I understand that by agreeing to this clause I am releasing claims and giving up substantial rights, including my right to sue.

YES. I have read this statement and by selecting "YES" it acts as my signature.

No. I need more information about this and do not want to sign this statement.

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