Western MA Regional 4-H Horse Judging
Sunday, January 28, 2024 
8:30 AM - 12:00 PM 
Coggin Creek Stables 
1008 Granville Road, Westfield MA 01085 

Please check email in case of weather cancellation. 

Please submit this form by January 19th.

If you have any questions or concerns please reach out to Carrie Chickering-Sears.
Email: ccsears@umext.umass.edu
Phone: (413) 545-5302
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Email *
Contestant's First Name *
Contestant's Last Name  *
Street/PO Box *
City/Town *
State *
Zip Code *
Contestant's Date of Birth *
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/
DD
/
YYYY
4-H Club *
4-H County *
Emergency Contact Name *
Best Phone Number to Reach Emergency Contact *
Division *
Any contestant with a disability that requires an accommodation must provide the letter from their 4-H educator stating the areas or classes that require accommodations. Please also list any accommodations needed here.

If you have any questions or concerns please reach out to Carrie Chickering-Sears.

Email: ccsears@umext.umass.edu
Phone: (413) 545-5302

If this information is not provided before the contest, we may not be able to provide the necessary accommodations.
Would the contestant's parent / guardian be willing / able to volunteer during the day.   *
Volunteer Information
If you answered yes to the above question please fill out the following contact information.  We will reach out to you separately with volunteer information.  Thank you for your willingness to help us at this event! 
Volunteer's Name 
Volunteer's Email 
A copy of your responses will be emailed to the address you provided.
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