2021 Summer Workshop Series Registration

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Please complete the form below to register for any 2021 Washington County 4-H Workshop you plan to attend. One form must be completed for each youth. Open to ALL, 4-H Members and non 4-H Members.

ALL Payments will need to be received at the Nebraska Extension in Washington County Office for all workshops by May 17, 2021. You may stop in to pay or mail a check (please do not send cash in the mail)!

ALL Workshops will be held at the Washington County Extension Office in Blair.
597 Grant Street
Blair, NE 68008

Questions? E-mal All 4-H Staff at washingtoncounty4h@unl.edu or call 402-426-9455.

Email *

Participant Information

Youth Name (First, Last) *

Age (as of January 1, 2021) *

Address *

Phone Number *

Day of Emergency Contact and Phone # *

Please list any food allergies, if attending Culinary Challenge, Cooking 301 or Learn, Grow, Eat & Go Workshops.

Is the youth attending the workshop a 4-H member?

Yes

Clear selection

Extension Staff will occasionally take photographs or videos of children participating in the Summer Workshop Series. Check below whether or not you give permission to Nebraska Extension-Washington County to use these on our Facebook or other promotional pieces? *

I GIVE PERMISSION

I DO NOT GIVE PERMISSION

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms