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2007 Junior
Conference
Registration Form
More Information
Junior Conference
Registration Form
Name _________________________________ Age (1/1/07) ____________
Address ________________________________________________________
________________________________________________________
Phone _____________________ Email________________________________
Club ____________________________________________________________
Roommate Preference (not guaranteed)____________________________
In case of Emergency, contact:
Name________________________ or:
Name____________________________ Telephone_______________________ Telephone ______________________
Relationship_____________________ Relationship _____________________
Cell Phone: _____________________
Any special health conditions, care,
allergies, behavior or physical limitations, prescriptions and directions or
other, please list:
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
University of Rhode Island 4-H Member Code of Conduct
All 4-H
members are expected to demonstrate the character traits of honesty, respect
for others, responsibility, fairness, caring and good citizenship.
- Be courteous, thoughtful and fully cooperate
with other 4-H members and adults at all 4-H sponsored events.
- Respect the rights of others and their
property.
- Treat all people fairly and animals
humanely.
- Participate in a positive and enthusiastic
manner.
- Show good judgment and put safety first.
- Be honest and follow through with
commitments.
- Always try to make your best better.
- Obey all rules and accept responsibility for
your decisions.
- Exhibit dignified and restrained actions in
expressing affection towards others.
- The possession, consumption, ingestion or
inhalation of an intoxicating beverage or drug is strictly forbidden.
4-H Members Agreement:
I have read the code
of conduct and understand that failure to comply with these rules will result
in immediate expulsion from the Conference and/or denial of participation in
future programs. The Conference Adults and Teen Staff will enforce the rules
of conduct.
Member’s Signature________________________
date____________
Parent/Guardian Agreement
I have read the code
of conduct and endorse the enforcement of said rules. I give permission
for_________________ to participate in the RI 4-H Junior Conference, August
1-2, 2007.
To the best of my knowledge, my child is in good health and can
participate in this activity. I have noted any special accommodations needed
and have provided emergency contact information. In case of emergency, I give
permission for immediate medical treatment.
I understand that persons participating in this event do so at
their own risk and hold harmless the University of Rhode
Island, College of the Environment and Life
Sciences, the 4-H Youth Development Program, the conference planning
committee and the 4-H staff and chaperones. I accept responsibility for any damage
to persons or property caused by my child’s participation in this
event.
Signed__________________________________
Date_______________
____I am a 4-H volunteer and I would like to be a chaperone.
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