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4-H Clover Kid Day Camp
Friday, June 21st 9:00 AM - 12:00 PM or 1:00 - 4:00 PM, ages 5-7. Cost $15.00-no refunds. Register by June 10th, payment must be made to the Extension office by June 10th.
At the 4-H Building in Auburn.
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Name:
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Which Session will you be attending?
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Session 1: 9:00 AM - 12:00 PM
Session 2: 1:00 PM - 4:00 PM
Age/Grade entering:
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Race/Ethnicity
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American Indian or Alaska Native
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Parent's Name:
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Email
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Address:
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Emergency Contact #:
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I agree that registration is not final until payment has been made at the Nemaha County Extension office by June 10th. Please make checks to the University of Nebraska - Lincoln.
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Special Accommodations Needed or Food Allergies
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I give permission to use my child's image taken in photographs to be used publications, advertisements, news articles or websites.
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I give permission for my child to attend the Clover Kid Day Camp.
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Name of parent or adult filling out form:
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