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The Oklahoma 4-H Youth Enrollment Form is a crucial document designed to facilitate the enrollment process for young individuals interested in participating in the 4-H program. This form collects essential information from families, including contact details, emergency contacts, and demographic information, ensuring that each youth member is properly registered and supported throughout their 4-H journey. Required fields, marked with an asterisk, must be completed to ensure accurate records. The form also includes sections for parent or guardian information, allowing for effective communication and coordination. Additionally, youth participants are encouraged to select their preferred 4-H projects, which can range from agriculture to technology and arts, fostering their interests and skills. The form emphasizes the importance of parental consent, medical information, and adherence to the 4-H Code of Conduct, ensuring a safe and supportive environment for all members. By thoroughly completing this enrollment form, families contribute to a well-organized program that nurtures youth development and community engagement.

Important Questions on Oklahoma 4 H Youth Enrollment

What is the Oklahoma 4-H Youth Enrollment Form?

The Oklahoma 4-H Youth Enrollment Form is a document that allows youth to officially enroll in the 4-H program in Oklahoma. It collects essential information about the youth member, their family, and their interests in various projects. This form is crucial for participation in 4-H activities and ensures that all necessary details are recorded for effective communication and support.

Who needs to fill out the enrollment form?

Any youth who wishes to join the Oklahoma 4-H program must complete the enrollment form. This includes new members as well as those who may be transferring from another county or state. It is essential for ensuring that all participants are accounted for and can receive the appropriate resources and information related to their 4-H experience.

What information is required on the form?

The form requires several pieces of information, marked with an asterisk (*) to indicate their importance. This includes the member's name, birth date, gender, contact information, and details about their family. Additionally, members must specify their preferred correspondence method and enroll in at least one 4-H project. Providing accurate and complete information is crucial for successful enrollment.

What if I am transferring from another county or state?

If a youth member is transferring their enrollment from another county in Oklahoma or from another state, they should provide that information on the form. This process helps to ensure a smooth transition and allows the new county to update their records accordingly. If the member has never been enrolled before, this section does not need to be filled out.

What are the project options for enrollment?

Members must enroll in at least one project, with a limit of five. The form lists a variety of project options, ranging from agriculture, arts, and sciences to leadership and personal development. Each project provides unique learning opportunities, allowing youth to explore their interests and develop new skills. It is important to choose projects that align with the member's interests to enhance their 4-H experience.

How is medical information handled in the enrollment process?

The enrollment form includes a section for medical information, which is critical for ensuring the safety of participants during activities. Parents or guardians must provide accurate medical history and any relevant information that may affect the child's participation. This information is kept confidential and is only shared with authorized personnel in case of an emergency.

What happens if the form is not completed correctly?

It is vital to fill out the enrollment form completely and accurately. Missing or incorrect information can delay enrollment and may prevent the youth from participating in 4-H activities. If there are any questions or uncertainties while completing the form, it is advisable to reach out to local 4-H leaders or extension staff for assistance. Prompt attention to these details will help ensure a smooth enrollment process.

How to Write Oklahoma 4 H Youth Enrollment

Completing the Oklahoma 4-H Youth Enrollment form is an important step for youth interested in participating in 4-H activities. This form gathers essential information about the member and their family, ensuring that everyone is informed and prepared for the upcoming year. Follow these steps to fill out the form accurately.

  1. Gather necessary information. Collect details such as family names, addresses, phone numbers, and email addresses before starting the form.
  2. Fill out family information. Enter the required fields marked with an asterisk (*), including the family’s last name, mailing address, city, zip code, primary phone number, and email address.
  3. Select correspondence preference. Indicate whether you prefer to receive communications via mail or email.
  4. Provide member information. Complete the member’s last name, first name, middle name, preferred name, birth date, and gender. Also, include the member's email and cell phone number.
  5. Indicate years in 4-H. Write the number of years the member has been involved in 4-H.
  6. Fill out parent information. Provide details for both parents, including their first and last names, cell phone numbers, and work phone numbers.
  7. Complete secondary household information. If applicable, provide the mailing address and email for a second household.
  8. List an emergency contact. If different from Parent 1, include the emergency contact’s name, phone number, cell phone number, email, and relationship to the member.
  9. Indicate military service. Answer whether any family member is currently serving in the military.
  10. Fill out school information. Include the school county, district, name, and grade in school.
  11. Provide Native American information. If applicable, list the tribe name or indicate if not a member of a tribe.
  12. Select t-shirt size. Choose the appropriate size for the member’s t-shirt.
  13. Enroll in 4-H clubs and projects. Name the primary club and select at least one project from the provided list.
  14. Review participant authorizations. Carefully read and check the boxes for permissions related to conduct, medical information, publicity, and surveys.
  15. Sign the form. Both the member and a parent/guardian must sign and date the form to complete the enrollment process.

Once the form is completed, submit it as instructed, and look forward to an exciting year in 4-H! Be sure to keep a copy for your records.

Similar forms

The Oklahoma 4-H Youth Enrollment form shares similarities with the school enrollment form commonly used by educational institutions. Both documents require essential information about the student, such as name, address, and contact details. They also collect demographic data, which helps organizations understand the backgrounds of their participants. Just as schools use enrollment forms to maintain accurate records and ensure student safety, the 4-H form serves to track youth participation and facilitate communication between the organization and families.

Another document that parallels the Oklahoma 4-H Youth Enrollment form is the medical release form. Both forms emphasize the importance of health information to ensure the safety of participants. The medical release form collects data regarding any pre-existing conditions, allergies, or medications, similar to how the 4-H form requires medical information for emergencies. This information is crucial for staff to provide appropriate care and respond effectively in case of health-related incidents during activities.

The consent form for participation in extracurricular activities is also comparable. Like the 4-H Enrollment form, it seeks parental consent for a child’s involvement in various programs. Both documents outline the responsibilities of parents and guardians, ensuring they understand the activities their children will engage in. They also address liability issues, making it clear that participation is voluntary and that parents must accept certain risks associated with these activities.

Similarly, the youth sports registration form shares characteristics with the 4-H Enrollment form. Both documents gather personal information about the participant, including emergency contacts and health history. They also require parents to acknowledge the rules and regulations governing participation. This helps create a safe environment for youth by ensuring that all involved understand the expectations and consequences of participation.

The summer camp registration form is another document with notable similarities. Both the camp and the 4-H forms collect personal information, including emergency contacts and medical history, to ensure the safety of participants. Additionally, both forms often include sections for consent and liability waivers, emphasizing the importance of informed participation. This helps organizations manage risks while providing enriching experiences for youth.

The scholarship application form also bears resemblance to the Oklahoma 4-H Youth Enrollment form. Both require personal and demographic information to assess eligibility and background. Additionally, they often include sections for parental consent and acknowledgment of program requirements. This ensures that applicants understand the commitments involved, whether in a scholarship program or 4-H activities.

The volunteer application form used by many organizations mirrors the 4-H Enrollment form in its structure and purpose. Both documents seek detailed personal information, including contact details and background checks. They also emphasize the importance of understanding the organization’s mission and the responsibilities of the role. This ensures that volunteers are well-informed and prepared to contribute positively to the program.

For those looking to draft a comprehensive Bill of Sale, it's essential to understand its importance in safeguarding both the buyer's and seller's interests during a transaction, and for additional resources, you can visit legalpdf.org for templates and guidance.

Another similar document is the youth club membership application. Like the 4-H Enrollment form, it collects essential information about the youth member, including contact details and parental consent. Both documents also highlight the importance of participation in club activities and often include sections for project selection. This fosters engagement and commitment to the club’s mission, similar to the objectives of 4-H.

The field trip permission slip is also akin to the 4-H Enrollment form. Both documents require parental consent for participation in activities outside the regular program. They gather essential information, such as emergency contacts and medical history, to ensure the safety of participants. Additionally, they inform parents about the nature of the activities and any associated risks, fostering transparency and trust between the organization and families.

Finally, the event registration form used for community programs shares similarities with the Oklahoma 4-H Youth Enrollment form. Both forms require personal information and emergency contacts to ensure participant safety. They also often include sections for consent and acknowledgment of rules, ensuring that participants and their guardians understand the expectations and responsibilities associated with the event. This helps create a structured and safe environment for all involved.

Example - Oklahoma 4 H Youth Enrollment Form

OKLAHOMA 4-H YOUTH ENROLLMENT FORM

2015-2016

 

 

IMPORTANT: FIELDS MARKED WITH * ARE REQUIRED – DO NOT SKIP! FAMILY INFORMATION

*E-Mail: _____________________________________________ *Last Name: ______________________________

*Mailing Address: _______________________________________________________________________________

*City:________________________________, OKLAHOMA *Zip Code: ___________________________________

*Primary Phone: ____________________________

*Correspondence Preference: Mail E-Mail

Are you in a Military 4-H Club? Yes No

 

MEMBER INFORMATION

 

Member E-Mail: _______________________________________

*Last Name: ______________________________

Middle Name: ________________________________________

*First Name: _____________________________

Preferred Name (if different than first name):_________________________________________________________

*Birth Date (MM/DD/YYYY): ____________________________

*Gender: Female Male

Correspondence Preference: Mail E-Mail

Cell Phone: ____________________________

Do you wish to receive notices via text message? Yes No

If yes, Cell Phone Provider: __________________

*Years in 4-H: __________

 

PARENT 1 INFORMATION

 

*First & Last Name: __________________________________

Cell Phone: ________________________________

Work Phone/Extension: _______________________________

PARENT 2 INFORMATION

First & Last Name: __________________________________ Cell Phone: ________________________________

Work Phone/Extension: _______________________________

SECONDARY HOUSEHOLD INFORMATION

Does Email/Mail need to be sent to a Second Household? Yes No

Mailing Address: ________________________________________________________________________________

City:________________________________, OKLAHOMA Zip Code: _____________________________________

Second Household E-Mail: ________________________________________________________________________

EMERGENCY CONTACT

If Emergency Contact for this member is different than the parent 1 information above, please complete the information below.

*Emergency Contact Name: ___________________________________ *Phone Number: _____________________

Cell Phone Number: _________________________________ E-Mail: ______________________________________

*Emergency Contact Relationship (Mom, Dad, Aunt, etc.): _______________________________________________

VOLUNTEER - * Are you a certified 4-H Volunteer? (Teen Leader-13 and up) Yes No

Effective 6/1/2015

Page 1 of 6

DEMOGRAPHIC INFORMATION

 

*Are you of Hispanic or Latino ethnicity? Yes No

 

*Race (Check all that apply): White Black/African American

American Indian/Alaskan Native

Native Hawaiian/Pacific Islander

Asian Balance (other combinations)

Prefer not to state

 

*Residence: Farm Town under 10,000/Rural Non-Farm Town/City 10,000-50,000 and its suburbs

Suburb of city more than 50,000

Central city more than 50,000

MILITARY SERVICE OF FAMILY

 

*Family Member Military Service: No Parent Serving

Sibling Serving

SCHOOL INFORMATION

 

*School County: ___________________________ *School District: _______________________________________

*School Name: __________________________________________________ *Grade in School: ________________

NATIVE AMERICAN INFORMATION

Tribe Name: __________________________________ Not a member of a tribe

T-SHIRT SIZEYouth _______ Adult _______

*4-H CLUB AND PROJECTS - Name of Primary Club: ___________________________________________

Other 4-H Clubs you are associated with_____________________________ ______________________________

Youth must enroll in at least one (1) 4-H project and are limited to 5 projects. Through proje t ork, outh lear -to-lear independent study, project meetings and participation in workshops, tours, seminars, and camps. Check the projects you wish to enroll in from the list below.

A to D

Aerospace & Rocketry

ATV

Automotive

Beef

Bicycle

Childcare, Child Development

Citizenship Government, Service Learning and Community Service

Communication Arts - Graphics, Writing/Poetry, Print, Story Telling, Filmmaking, Photography

Companion Animals Dog, Cat, Pocket Pets, Guinea Pigs, Birds, Fish, Reptiles, Other

Consumer Education

Dairy

Design and Construction - Apparel and Sewing

Design and Construction - Hobbies and Textiles: Quilting, Knitting, Embroidery, Crochet, Fabric art, Crafts and Sewing

Design and Construction - Interiors, Personal Living Space and Sewing

E to H

Electricity & Electronics

Energy - wind, electric, hydro, solar, gas, oil, coal, etc.

Entomology and Bees

Entrepreneurship

Environmental Stewardship - Recycling, Composting, Water Conservation, etc.

Expressive Arts: Visual Arts, Drawing, Painting, Sculpture, Crafts, Leather, etc.

Farm Machinery

Flower Gardening & House Plants

Foods and Nutrition - Breads, Cooking/ Preparation, Preservation, Presentation, etc.

Gardens - Fruits/Vegetables

Goats meat, milk and hair

Health & Fitness

Hobbies and Collectables

Horse, Donkey, Mule

I to P

Industrial Arts - woodworking, welding, construction, etc.

International/Cultural Education - exchange programs, service abroad, education abroad

Leadership

Llama

Meats

Meteorology - Weather and Climate

Natural Resources - Wildlife and Fisheries, Game Birds, Forestry, Geology, Range

Ornamental Horticulture & Landscaping

Outdoor Education - Camping, Recreation, High Adventure, Hiking, etc.

Performing Arts: Dance, Drama, Theater, Clowning, Mime, Music, etc.

Personal Development

Photography

Plant and Soil Sciences

Postmark

Poultry

Public Speaking

R to V

Rabbits

Recreation and Leisure Education

Robotics

Safety - Home, Farm, School, Personal

Science Engineering and Technology - TechXcite, GPS,

UAV, Co puter “ ie e, et …

Sheep

Shooting Sports - .22 Pistol

Shooting Sports - .22 Rifle

Shooting Sports - Air Pistol

Shooting Sports - Air Rifle

Shooting Sports - Archery

Shooting Sports Hunting and Wildlife

Shooting Sports-Muzzle Loader

Shooting Sports Shotgun

Shooting Sports Western Heritage

Small Engines

Sportfishing

Swine

Tractor and Machinery Safety

Vet Science

Effective 6/1/2015

Page 2 of 6

Oklahoma 4-H Youth Development

 

* Youth Participant Authorizations

All boxes must be answered

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Code of Conduct – We have read the Code of Conduct on page 5 and understand that failure to

 

Agree

 

 

abide by published and implied policies and regulations, including Code of Conduct, governing

 

 

 

a 4-H program may result in loss of membership privileges.

 

 

 

 

 

 

 

 

 

 

 

 

 

Electronic Communication w/Youth - I give permission for my student/child to receive direct

 

 

 

 

 

 

email/social media/text communications from 4-H/OCES staff/volunteers for

Consent

 

Decline

 

 

educational/programming purposes. I understand that I have a right to request a copy and

 

 

 

Given

 

communication

 

 

receive the same information my child does. I give my child permission to communicate with

 

 

 

 

 

directly w/youth

 

 

educator(s)/volunteers/leaders via same said means. I understand I can withdraw permission for

 

 

 

 

 

 

 

my child to participate at any time by giving written notice to the staff member responsible.

 

 

 

 

 

 

 

 

 

Complete guidelines may be found in 4-H Membership Guidelines.

 

 

 

 

 

 

Informed Consent, Voluntary Waiver, and Release - We have read the Liability Release on page

 

 

 

 

 

 

6 a d ha e ee i for

ed of the U i ersit ’s a d 4-H Youth Developments position on Liability

 

Agree

 

 

and Assumption of Risks.

 

 

 

 

 

 

 

 

 

 

 

 

 

Medical Release and Prescription Medication - YOUTH MEDICAL INFORMATION - Oklahoma

 

 

 

 

 

 

State University requests the use of 4-H Youth Participation Form 1, pages 1 and 2 in case of

 

 

 

 

 

 

emergency, we need accurate information to provide and/or seek appropriate treatment for

 

 

 

 

 

 

Participant. You are accountable for providing an accurate medical history. If Participant has any

 

 

 

 

 

 

medical issue that is not requested on the form, but which you think is important, please include

 

 

 

 

 

 

that information. If you are uncertain about any pre-existing medical conditions, it is your

I understand the position of OSU

 

 

and 4-H Youth Development in

 

 

responsibility to consult with your own physician prior to participation in a Program. As a

 

 

the care and treatment of my

 

 

participant, parent, or guardian it is your responsibility to disclose relevant information that may

 

 

 

 

child.

 

 

result in harm to Participant and/or others during this Program. By signing this form, I represent

 

 

 

 

 

 

 

 

 

 

and warrant that I have/will provided all materials and important information to Oklahoma State

 

Check one

 

 

U i ersit pertai i g to

Parti ipa t’s edi al, e tal a d ph si al o ditio a d that it is

 

 

 

Medical Form(s) will be

 

 

accurate and complete. I agree to notify the 4-H program and or Oklahoma State University of

 

 

completed as needed

 

 

any changes in the mental, physical or medical condition of the Participant prior to any scheduled

 

 

Medical form to be filled

 

 

Program.

 

 

 

By revealing or disclosing the medical information it will not be used by Oklahoma State

out by family and can be

 

 

uploaded and stored

 

 

University personnel or employees to deter i e Parti ipa t’s a ilit to parti ipate safel i

 

 

electronically to be used

 

 

activities. I understand that, if Participant chooses to participate in activities, he/she does so

from Sept 1-Aug 31 each

 

 

voluntarily and of his/her own accord and the final decision regarding participation is solely the

year

 

 

 

 

 

responsibility of myself and Participant. Final determination about whether to participate is the

Medical form to be filled

 

 

responsibility of you and your physician. This information will be kept in strict confidence and

out by family and kept on

 

 

will only be shared with your permission.

file in the Extension Office.

 

 

In cases where medical attention is necessary, parent/guardian will be contacted for approval

The form is only valid Sept

 

 

1- Aug 31 each year.

 

 

when possible; however, in the event of an emergency the 4-H staff will seek medical care for any

 

 

 

 

 

 

 

 

child in their care. Oklahoma State University does not offer any form of insurance for participant

 

 

 

 

 

 

while participating in Programs. Full medical expense will be the responsibility of parent or

 

 

 

 

 

 

guardian. To see the Medical Form in its entirety go to http://4h.okstate.edu/events-and-

 

 

 

 

 

 

activities/forms.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Publicity Release - We give permission for use of name and/or picture for

 

 

Decline do not

 

 

print/photo/video/electronic media use (including but not limited to local newspaper, social

Consent

 

use the hild’s

 

 

media, etc.) of the member to appear for any wide variety of formats and media for marketing,

Given

 

name and/or

 

 

 

 

photo for any

 

 

promotional or educational purposes. Complete guidelines may be found in 4-H Membership

 

 

 

 

 

publicity.

 

 

Guidelines.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Survey and Evaluation Release - We give permission for the member to participate in and/or

 

 

 

 

 

 

complete surveys and evaluations that will be used to determine program effectiveness or to

 

 

 

 

 

 

promote the program.

 

Consent

 

 

 

 

 

We understand that participation in surveys and evaluations is voluntary and that the member

 

Decline

 

 

Given

 

 

 

 

participation

 

 

may choose to not participate without any impact on his or her ability to participate in the

 

 

 

 

 

 

 

program.

 

 

 

 

 

 

 

 

 

 

We understand that the member will be asked for his or her verbal assent before completing a

 

 

 

 

 

 

survey or evaluation.

 

 

 

 

 

 

 

 

Be sure to sign the next page to complete the Authorization Agreement

 

 

 

Effective 6/22/2015

 

 

 

Page 3 of 6

Oklahoma 4-H Youth Development

Our signature indicates that:

We have read this entire enrollment package and agree to help this member in the projects in which he/she has enrolled.

4-H Member Signature________________________________________________________________

Date ________________

Parent/Guardian Signature____________________________________________________________

Date ________________

 

 

TRANSFERRING MEMBERSHIP FROM ANOTHER STATE OR COUNTY:

If you are new to this county and were enrolled in 4-H in another county in Oklahoma or another state, please provide the information below and we will transfer your membership to this county. If you have never been enrolled as a 4-H member before or there was a lapse in membership of a year or more, this information is not needed.

Oklahoma County transferring enrollment from: __________________________________________________

OR

State and county transferring enrollment from: ___________________________________________________

Effective 6/22/2015

Page 4 of 6

Oklahoma 4-H Youth Development

CODE OF CONDUCT - Rules and Disciplinary Procedures

Rules Participants and Parents Need to Know:

I.In seeking uniformity in the conduct expected at each county, district, state, national, and international 4-H event, the following guidelines have been developed.

Each participant has a reasonable expectation to enjoy a positive program experience. Therefore, the misbehavior of one participant, or a group of participants, will not be permitted to impact negatively on the program experience of others. Most programs are short in duration, so prompt action is required when problems occur.

 Realizi g these guideli es are ot all i lusi e , the E te sio “er i e reser es the right to ake adjust e ts to poli ies.

All rules and regulations governing an activity, event or facility use will be discussed with educators, certified volunteers, parents and 4-H'ers prior to or at the beginning of each event.

All 4-H'ers are under the supervision of any Extension staff or certified volunteer assigned to the event.

If the 4-H'er is found in violation of the Code of Conduct and disciplinary action is required his/her parent/guardian will be notified immediately and the 4-H'er may be suspended from participation in district, state, national and international 4-H activities and/or membership revoked. As deemed necessary, the appropriate County, District or State 4-H Office will be notified of disciplinary action.

If in the event any the misconduct is deemed in violation of a law, the appropriate law enforcement agency will be notified.

Participants dismissed from a program for disciplinary reasons will not receive a refund on any fees paid to attend.

If a 4-H'er wishes to appeal the disciplinary action he/she must appeal in writing through their County Extension Office. Appeals must be filed within 30 days following notification of punishment. As necessary, the State 4-H Leader shall appoint an appeal board, no sooner than 30 days following the date of notification of the disciplinary action.

Participants are responsible for securing their belongings. Neither Oklahoma State University, nor ext. staff or certified

volunteer, is responsible for lost or stolen items. Leave excess money and valuables at home. Valuables brought to the program are at participants’ risk and can only be used at free or other authorized times.

II. The following actions will be considered a serious breach in conduct. This is not an all-inclusive list of conduct violations.

Assault or Personal Harm – Inflicting physical or emotional harm on self or others.

Prohibit the possession, distribution, sale or use of illegal drugs/substances, alcoholic beverages; any form of tobacco or vapor products, fireworks; and/or weapons (does not limit the use of approved sporting arms when and where authorized).

Sexual Misconduct - Coed visitation in the residence halls is permitted in designated common areas only not in sleeping rooms.

No boys will be allo ed i girls’ roo s or ill girls e allo ed i o s' roo s, either as i di iduals or groups. It is re og ized that circumstances may arise for justifiable exceptions to this rule. However, in every case, permission for exceptions must be secured from chaperone in advance.

Theft, Misuse or Abuse of Public or Personal Property - Any damages caused by neglect or misuse will be charged to the responsible party. Replacement cost will be charged to anyone who removes or damages property. Any individual found tampering with any fire equipment (i.e. fire extinguishers, fire alarms, smoke detectors, etc.) will be dismissed from the Program immediately. Participants may not interfere with any security system or tamper with locks in participant rooms and other areas. All furniture must remain unchanged and kept in place.

Search of Property - If a question regarding any of the above is raised, 4-H member consents to a search of his/her room and/or personal property. Failure to comply will result in violation of the Code of Conduct.

III.The following actions will be considered a breach in conduct. This is not an all-inclusive list of conduct violations.

Breaking curfew and/or disturbing the peace - Participants will abide by nightly curfews and remain in there until morning.

Violating the Dress Code

Use of Abusive and Offensive Language

Bullying and Harassment – Physical, emotional or electronic harassment/harm against self, fellow participants or staff.

Vandalism and Pranks will not be permitted.

Unexcused Absence from the activities of the event - Participants are to remain on the event site and attend all workshops, classes, and planned social or recreational activities for the duration of the program unless program activities require otherwise. If a participant needs to leave campus or event site for some reason, supervising ext. staff or certified volunteer must have prior written approval from the parent or guardian, and agree to grant specific permission.

Unauthorized use of Vehicles during the event - Participants are not allowed to drive or ride in personal vehicles during the dates of the program unless they receive specific permission to do so from their supervising extension staff or certified volunteer. While we understand that some participants will drive to the event, our rule is that participants should not be driving during the event. Participants may be asked to turn their car keys in to the supervising staff or certified volunteer for the duration of the program.

Misuse of Technology - Participants must never misuse internet, social media, cell phone or any new technological devices. Accessing or sending unauthorized or inappropriate content is strictly prohibited.

Effective 6/22/2015

Page 5 of 6

Oklahoma 4-H Youth Development

Informed Consent, Voluntary Waiver, Release of Liability & Assumption of Risks

I, the undersigned, wish for my Child (hereafter Child ) to participate in the above referenced youth program (hereafter Program ) on the date(s) and location(s) indicated above and, in consideration for my Childs

participation, I hereby agree as follows:

I acknowledge, understand and appreciate that as part of my Child’s participation in the Program there are dangers, hazards and inherent risks to which my Child may be exposed, including the risk of serious physical injury, temporary or permanent disability, and death, as well as economic and property loss. I further realize that participating in the youth program may involve risks and dangers, both known and unknown, and have elected to allow my Child to take part in the Program. Therefore I, on behalf of my Child, voluntarily accept and assume all risk of injury, loss of life or damage to property arising out of training, preparing, participating, and traveling to or from the Program.

I, on behalf of my Child, hereby release Oklahoma 4-H, Oklahoma State University, its Board of Regents, Administration, Faculty, Staff, Student Leaders, the Program Staff, and all other officers, directors, employees, volunteers and agents (hereafter OSU ) from any and all liability as to any right of action that may accrue to my heirs or representatives for any injury to my Child or loss that my Child may suffer while training, preparing, participating and/or traveling to or from the above indicted event. This agreement is binding on my heirs and assigns.

In the event of an accident or serious illness, I hereby authorize representatives of OSU to obtain medical treatment for my Child on my behalf. I hereby hold harmless and agree to indemnify OSU from any claims, causes of action, damages and/or liabilities, arising out of or resulting from said medical treatment. I further agree to accept full responsibility for any and all expenses, including medical expenses that may derive from any injuries to my Child that may occur during his/her participation in the Program.

This RELEASE shall be governed by and construed under the laws of Oklahoma. I agree that any legal action or proceeding relating to this RELEASE, or arising out of any injury, death, damage or loss as a result of my Childs participation in any part of the Program, shall be brought only in Payne County, Oklahoma.

This RELEASE contains the entire agreement between the parties to this agreement and the terms of this RELEASE are contractual and are not all inclusive. The information I have provided is disclosed accurately and truthfully. I have been given ample opportunity to read this document and I understand and agree to all of its terms and conditions. I understand that I am giving up substantial rights (including my right to sue), and acknowledge that I am signing this document freely and voluntarily, and intend by my signature to provide a complete and unconditional release of all liability to the greatest extent allowed by law. My signature on this document is intended to bind not only myself and my Child but also the successors, heirs, representatives, administrators, and assigns of myself and my Child.

Effective 6/22/2015

Page 6 of 6

Documents used along the form

The Oklahoma 4-H Youth Enrollment form is essential for youth wanting to participate in the 4-H program. However, several other documents often accompany this form to ensure a smooth enrollment process and provide necessary information for both participants and organizers. Below are some of the key documents that are typically used alongside the enrollment form.

  • Medical Release Form: This document is crucial for ensuring the health and safety of participants. It requires parents or guardians to provide detailed medical information about the youth, including allergies, medications, and any pre-existing conditions. This information is vital in case of emergencies.
  • Liability Waiver: This form protects the organization by outlining the risks associated with participation in 4-H activities. Parents or guardians must sign this waiver to acknowledge that they understand the potential risks and agree not to hold the organization liable for any injuries that may occur.
  • Code of Conduct Agreement: Participants are expected to adhere to certain behavioral standards during their involvement in 4-H. This document outlines the rules and expectations for conduct, helping to create a positive environment for all members.
  • Publicity Release Form: This form grants permission for the use of a participant's name and image in promotional materials, including photos and videos. It ensures that parents or guardians are aware of how their child's likeness may be used in marketing efforts.
  • Incorporation Documents: Similar to the 4-H forms, submitting the necessary incorporation documents, such as the California Articles of Incorporation form, is vital for establishing a business entity. For more details, visit legalformspdf.com.
  • Survey and Evaluation Release: Participation in surveys or evaluations helps improve the program. This document allows participants to take part in feedback opportunities that assess the effectiveness of the 4-H program.

These documents work together with the Oklahoma 4-H Youth Enrollment form to facilitate a comprehensive and safe enrollment experience. By understanding the purpose of each form, parents and guardians can better prepare for their child's participation in the 4-H program.

Key takeaways

  • Required Fields: Always complete fields marked with an asterisk (*) to ensure your form is processed correctly.
  • Family Information: Provide accurate family details, including mailing address and contact preferences, to facilitate communication.
  • Member Information: Fill in the member’s full name, birth date, and preferred name for identification purposes.
  • Emergency Contact: List a reliable emergency contact who can be reached if needed, separate from the parents.
  • Volunteer Information: Indicate if the member is a certified 4-H volunteer, which may open up additional opportunities.
  • Demographic Information: Complete this section to help 4-H understand its participants better, including ethnicity and residence.
  • Project Enrollment: Members must enroll in at least one project and can choose up to five; select projects that interest the member.
  • Medical Information: Provide accurate medical details to ensure the safety and well-being of the member during activities.
  • Code of Conduct: Familiarize yourself with the rules and expectations outlined in the Code of Conduct to ensure a positive experience for everyone.