Cloverbuds @ Home Mini Camp Registration

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Join us for Cloverbuds @ Home Mini Camp! This program is designed for ANY youth in grades K-2, not just registered Cloverbud members. Each youth will receive a box with 5 months of hands-on learning activities, running December-April (boxes contain several supplies, but youth will be responsible for supplies not included – these are items you have around your house). Each month offers TWO different educational opportunities! One staff-lead Zoom meeting, and one on your own opportunity. Each Zoom meeting will start at 6:30 pm and run approx. 30-45mins, the dates are as follows; Thursday, December 9, Thursday, January 13,
Thursday, February 10, Thursday, March 10, and Thursday, April 14.

Sessions will be taught via Zoom and most supplies will be provided through your county's 4-H staff. A video recording of the session will be sent out after the meeting for those who cannot attend on Tuesday nights.

Enrollment closes on November 22

Email *

Parent/Family name *

County you are enrolled in? (If you are not yet enrolled in 4-H, pick the county that you live in.) *

Chippewa

Dunn

Eau Claire

St. Croix

Polk

Pierce

Pepin

Jackson

Trempealeau

Buffalo

Other:

Is there anything we need to know to help your family have a positive experience?

How many youth in your household will participate? *

How many boxes would you like for your household?

Clear selection

Participant Name #1

Participant #1 Grade

Pre K

Kindergarden

1st Grade

2nd Grade

Clear selection

Participant Name #2

Participant #2 Grade

Pre K

Kindergarden

1st Grade

2nd Grade

Clear selection

Participant Name #3

Participant #3 Grade

Pre K

Kindergarden

1st Grade

2nd Grade

Clear selection

Participant Name #4

Participant #4 Grade

Pre K

Kindergarden

1st Grade

2nd Grade

Clear selection

Demographics

If you are not currently enrolled in 4-H, please fill out the following demographic questions

Participant #1 Gender

Female

Male

Other

Clear selection

Participant #1 Ethnicity

Hispanic or Latino

Not Hispanic or Latino

Prefer not to say

Clear selection

Participant #1 Race (Check all that apply)

American Indian or Alaskan Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

Two or More Races

Prefer Not to Say

Participant #2 Gender

Female

Male

Other

Clear selection

Participant #2 Ethnicity

Hispanic or Latino

Not Hispanic or Latino

Prefer not to say

Clear selection

Participant #2 Race (Check all that apply)

American Indian or Alaskan Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

Two or More Races

Prefer Not to Say

Participant #3 Gender

Female

Male

Other

Clear selection

Participant #3 Ethnicity

Hispanic or Latino

Not Hispanic or Latino

Prefer not to say

Clear selection

Participant #3 Race (Check all that apply)

American Indian or Alaskan Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

Two or More Races

Prefer Not to Say

Participant #4 Gender

Female

Male

Other

Clear selection

Participant #4 Ethnicity

Hispanic or Latino

Not Hispanic or Latino

Prefer not to say

Clear selection

Participant #4 Race (Check all that apply)

American Indian or Alaskan Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

Two or More Races

Prefer Not to Say

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