May 4-H News. May 8, 2017

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1 510 N Pearl Street, Suite C / Wayne, NE / / FAX wayne-county@ unl.edu / Website: Facebook: https//facebook.com/unlextwaynecounty May 4-H News May 8, 2017 In this issue: Updates and Reminders Mid-Year Enrollment Deadline LENRD 4-H Camp Scholarships Need a 4-H T-shirt? 4-H Food Stand 4-H Fair Books State Fair Photography Theme Print Did You Know? Animal News Summer Events 4-H Policy Regarding Missed Deadlines Trophy Sponsors Needed Upcoming Animal Events UPDATES & REMINDERS *Citizenship Washington Focus (CWF 2018) - Youth ages on or before December 31, 2107 are eligible to participate in the CWF trip. Tentative dates are June 7-16, To reserve a spot, a down payment of $350 payable to University of Nebraska-Lincoln is due on or before June 1, 2017 to the Extension Office. All youth who are age eligible should have received a registration form in the mail. It is also available at wayne.unl.edu. *Raise Your Hand 4-H Alumni promotion lasts through June 30 and the 4-H Clover Chase through August 15. *Wayne County Fair Passes are available at the Extension Office. Volunteers received a postcard in April with details on purchasing halfprice passes. LOWER ELKHORN NATURAL RESOURCES DISTRICT 4-H CAMP SCHOLARSHIPS The LENRD will offer scholarships for youth to attend 4-H camps. The scholarships will reimburse each winner for the registration fee of the camp. Applications are available at under the Camps heading and the Extension Office. Applications are due by Friday, May 26 to the LENRD Office in Norfolk. MID-YEAR ENROLLMENT DEADLINE Copies of 4-H enrollments were sent to all 4-H leaders and members. If you did not receive your copy, contact the Extension Office immediately. Check your information carefully. Please log into your 4-H Online account to update contact information or to make project additions by midnight, June 15 (note new date). The website will not allow project changes after this time. See the letter that accompanied your 4-H enrollment information for instructions or contact the Extension Office. This is the last chance for 4-Hers to sign up for the projects they plan to exhibit at the fair. Also, check over project workshops you sign up for to make sure you are enrolled in the correct project. Fair entry deadline is July 6. NEED A 4-H T-SHIRT? 4-H livestock and small animal exhibitors are required to wear 4-H T-shirts or have a 4-H chevron on a white shirt. The 4-H T-shirts were re-designed in 2011; however 4-H T-shirts purchased in previous years are fine to wear. Cost is $10.00/T-shirt for youth S, M, L and adult S, M, L and XL sizes; 2X and 3X are $ Anyone, including parents and leaders, wanting to order a shirt should contact the Extension Office on or before June 1. 4-H FOOD STAND The 4-H Council is looking for adults who are interested in serving as the manager or as a day manager on Thursday, July 27, Friday, July 28, Saturday, July 29, or Sunday, July 30 for the 4-H Food Stand. Interested persons should contact the Extension Office for a list of responsibilities and an application.

2 4-H FAIR BOOKS The State 4-H Fair Book is online and the Wayne County Fair Book will be online soon. Check out and click on Wayne County 4-H. The links are under the County and State Fair Information heading. You will need adobe acrobat on your computer to read the files. Printed County Fair Books will be ready in June. STATE FAIR PHOTOGRAPHY THEME PRINT The 2017 State Fair 4-H Photography Nebraska Theme Exhibit Print class is described below. Both Unit II and Unit III will include this class. Reflect your definition of rural Nebraska. Capture rural living in our Nebraska County through your camera lens. Use your photo to express what rural means to you, why you value rural life, or how rural life is changing. This is your story to tell. ANIMAL NEWS ATTENTION HORSE EXHIBITORS The following are due by 5 PM, May 12. Horse ID s for District and State Horse Shows District & State Horse Show entries Horse Advancement Level Testing completed and signed books turned into the Extension Office, along with any needed reports for those entering the District and State Horse Shows. The area District 4-H Horse Shows are scheduled for June 12 in Lexington, June 14 in Wayne, & June 20 in Lincoln. Wayne is hosting the District Horse Show on June 14 at the Wayne County Fairgrounds. Please contact the Extension Office by May 12 if you are interested in volunteering to help. All 4-H Members have until June 15 to pass Horse Level 1 to exhibit at the County Fair, but all other levels must be passed by May 12 to count for classes entered in Note: Ranch Horse Pleasure (new class added for 2017) and 2-3 year-old Pleasure are Level 3 classes. Horse ID s for County Fair are due June 15. The Northeast Nebraska 4-H Horse Show will be held this year on June 1 st at Ridge Ranch Arena near Homer, NE. This is a great opportunity to help prepare for District Shows. The flyer can be found at: under Wayne County 4-H/4-H Animal Information and at the Extension Office. Early Bird Registration is due Friday, May 26, 2017 Thurston County Extension Office. 2 QUALITY ASSURANCE All 4-Hers enrolled in the market and breeding beef, bucket calf, feeder calf, cow/calf, dairy, dairy goat, meat goat, pygmy goat, market and breeding sheep, swine, rabbit and poultry projects can be certified by attending a class May 24, 1:00 p.m. & 6:00 p.m. at Wayne County Fairgrounds and on May 31, 1:00 & 6:00 p.m. at the Pierce County Courthouse. Youth can also become certified by completing an online course. The Youth Quality Care of Animals (YQCA) course is now active. Anyone who has not registered for the LQA online course for 2017 should now navigate to the NEW online YQCA course at yqca.learngrow.io. You will use your FAMILY 4HOnline login and password information to access the courses for the ACTIVE youth in your family. Only ACTIVE members will show in the drop down menu for access to the course. All registration questions with YQCA should be directed to help@yqca.org. There will not be local support for the YQCA program. All 4-Hers need to use the 4-H tab and not the FFA tab even if they are members of both organizations. There is a button for families that have forgotten their password. 4-Hers that have started their QA training in the LQA site will be able to complete their modules and print off their certificate of completion and take it to their Extension Office. The YQCA site is user friendly and should make it easy for 4-H families to complete their QA training for this year. Youth choosing to complete either on-line course must have their certificates turned into the Extension Office by June 15. Certificates can be ed, faxed or brought to the office. PASE & LIFE CHALLENGE - 4-Hers 10 years and older interested in participating in the state Livestock Judging or Life Challenge contests should contact the Extension office by May 26.

3 MORE ANIMAL NEWS ID INFORMATION All animals (except dog, cat, small animals and poultry) shown at the county fair must be identified on a 4-H identification form (affidavit). Make sure forms are filled out completely. No information will be taken over the phone. The deadlines will be enforced. Animal Horses Deadline District and State Horse Shows May 12 County Fair June 15 Market and Breeding Sheep May 18 Meat Goats May 18 Breeding Beef, Bucket Calf, Cow/Calf Pairs, Feeder Calf, Dairy Cattle, Goats, Market Swine, Rabbits June 15 Ak-Sar-Ben & State Fair June 15 DNA samples for Feeder Calves, Market Meat Goats, Market Sheep, and Market Swine Breeding Nomination Cards for Breeding Beef, Breeding Meat Goats, and Breeding Sheep Meat Goats will be weighed and tagged on May 18, 5:30 p.m. at the Wayne County Fairgrounds. Tags are $1.00 each. No tags can be taken home. Market goats must be tagged with a 4-H tag & does must have a USDA Scrapies tag. Breeding goats will not be weighed and their Scrapies tag can be used for identification, but they must be brought to weigh-in. Sheep will be weighed and tagged May 18, 6:00-7:30 p.m. at the Wayne County Fairgrounds. Tags are $1.00 each. No tags can be taken home. Market Sheep must be tagged with a 4-H tag & ewes must have a USDA Scrapies tag. Breeding Sheep will not be weighed and their Scrapies tag can be used for identification, but they must be brought to weigh-in. Mark RETURN on the ID sheet beside any yearling that was exhibited in the breeding lamb class in 2016 to be eligible for increased premiums. Ak-Sar-Ben and State Fair Requirements Market Animals (meat goats, sheep, swine) must be tagged with an EID Tag and have DNA sample on file. Cost is $8.00/animal. Feeder Calves must be tagged with an EID tag and have a DNA sample on file. Cost is $8.00/animal. Breeding Animals Beef: Tattoo and Breeding Nomination Card Meat Goats: Scrapies tag & Breeding Nomination Card Sheep: Scrapies tag and Breeding Nomination Card Cost: No charge Exhibitors with animals that have an EID tag must provide a premises ID by June 15. Breeding Nomination Cards, EID Tags, and DNA Envelopes are available at the Extension Office Cow/Calf Pairs - include ear tag number of calf as well as cow, age of cow, sex of calf and birth date of calf. Reminder to 4-Hers 11 years of age and older: The calf must be also ID d as either a breeding heifer or feeder calf. Reminder: Indicate if the pair is eligible for Renee Felt Herd Builder project. Breeding Beef and Cow/Calf Pairs - indicate home raised, county raised and return animals on the ID form. A cow shown as a breeding heifer at the 2016 county fair is eligible for increased premiums if noted as return on the 2017 ID form. All other cows are ineligible for the increased premiums. Bucket Calves and Feeder Calves need to be tagged with a 4-H ear tag. Tags can be purchased from the Extension Office for $1.00 each. Tagging needs to be done prior to the ID deadline. 4-H Rabbits - ID on County ID form and 3 close range photos (left side, right side, front view) or tattoo. Rabbits exhibited at the State Fair must be tattooed and entered into ShoWorks by August 10. ATTENTION CAT, DOG & HOUSEHOLD PET EXHIBITORS: Remember - proof of current vaccinations for cats, dogs and ferrets are due with fair entries on July 6 and must be current at that time. ATTENTION POULTRY EXHIBITORS NPIP Testing and a Poultry Showmanship Clinic is scheduled for July 10 at the 4-H Building. Testing will begin at 6:00 p.m. and the Showmanship Clinic will follow at 6:30 p.m. Please contact the Extension Office by 5:00 p.m., July 6 to tell us how many birds you will bring to be tested and to register for the clinic. 3

4 SUMMER EVENTS SUMMER EDUCATIONAL 4-H EVENTS Check out the enclosed flyer for summer events that are scheduled. Events include: Acrylic Painting Workshop Barn Quilt Workshop Birdfeeder Workshop Clover Kid Camps Crochet Workshop Dog Workouts Easy Table Runner Workshop Entomology Workshop Fairy or Miniature Garden Workshop Horticulture Contest Horse Showmanship Clinic (TBA) Photography Basics Workshop Pillowcase Workshop Ponca Day Camp Poultry Testing & Showmanship Clinic Pre-District Horse Show Equine Etiquette Clinic Quality Assurance Stars and Stripes Workshop Tractor Safety Training Welding Workshop Woodworking Workshop Yeast Bread Workshop OUTDOOR MOVIE EVENT Please join us on June 8, 9:00 p.m. on the Wayne City Library Lawn to watch a movie. Popcorn and drinks will be provided. All 4-Hers and families are welcome! PONCA 4-H CAMP INFORMATION Ponca Day Camp Attention 4-Hers ages 8-11! Reserve June 20 on your calendars and plan to attend Ponca Day Camp. Cost is $18.00, which will include activities, swimming and a noon meal. Camp will adjourn at 5:00 p.m. Ponca Day Camp Counselors are needed - Teens should be 14 years of age or older by June 1. Counselor training will take place June 19. Camp registrations and counselor applications are accepted until 5:00 p.m., June 9 at the Nebraska Extension-Dixon County office. Camp registration information is included with this month s newsletter and at Choose 4-H Camps under Wayne County 4-H in the red menu bar. Counselor applications are available online at the above address or at the Extension Office. TRACTOR SAFETY TRAINING The 2017 Tractor Safety Training is scheduled for June at the Wayne County Fairgrounds. Any youth years of age who work on a farm or ranch other than his/her parents is required to be certified through a tractor safety course. Extension Educators and field specialists will teach the 2-day course. Cost is $60, which includes materials, lunch both days, and snacks at breaks. Registration is due June 9. For details or to register, contact the Nebraska Extension Office in Dixon County at ( ). NEBRASKA YOUTH RANGE CAMP The Nebraska Youth Range Camp consists of a four-and-a-half day dynamic curriculum that appeals to students with a wide array of interests including, but not limited to, rangeland management, conservation, ecology, animal science, and wildlife. With over 50 years to perfect and evolve this curriculum, every student, no matter what prior experience they have, will learn substantial information that will help them become more aware of Nebraska s most prevalent land use; rangelands. The students that attend this camp will be actively involved with field activities, lectures, hand-on experience, and recreational leadership and team-building activities that are all led by up to 20 of Nebraska s most respected and dedicated leaders, teachers, and professionals from various agencies, colleges, and universities. Each student will be sent home with a binder that is filled with educational materials. The 54th Nebraska Youth Range Camp will be held June 5 9, 2017 at the Nebraska State 4-H Camp in Halsey. Eligible students need to be between the ages of Applications are accepted online this year and they can be found at More information about Range Camp can be found there as well! Fee for the camp is $200. The LENRD Scholarship can be used for this camp. Scholarship information can be found on the first page of the newsletter. Be sure and apply! 4

5 4-H POLICY REGARDING MISSED DEADLINES The 4-H Youth Development Program strives to instill responsibility in all 4-H members. Part of the responsibility is making sure that all 4-H deadlines are followed. It is the 4-H Council s role to be consistent and fair to all 4-Hers. Therefore, if a 4-Her contacts the Nebraska Extension Office after a missed county deadline, the 4-Her will be allowed to participate in county events, contests, etc., but will be ineligible for trophies and advancement to the State Fair. In the case where ID papers are late, we must follow the state deadline so opportunities to participate in events beyond the county are out the 4-H Council s control. TROPHY SPONSORS NEEDED The following trophies are available for sponsorship. Please contact the Extension Office if you or someone you know is interested. Cost is $18 per trophy. Champion Junior Floriculture Champion Senior Horticulture Champion Shopping in Style (Fashion Show) Champion Advanced Photography (Units 2 & 3) Champion Consumer Management Champion Beyond the Needle (12 and over) Champion Beyond the Needle (11 and under) Champion Human Development (11 and under) Champion Family & Consumer Science Miscellaneous (12 and over) Reserve Champion Fashion Show UPCOMING ANIMAL EVENTS Beef, Meat Goat, Sheep and Swine Beef-A-Rama Progress Show May 27, Boone County Fairgrounds, Albion Swine-A-Rama Progress Show May 27, Boone County Fairgrounds, Albion Sheep-A-Rama Progress Show May 28, Boone County Fairgrounds, Albion Goat-A-Rama Progress Show (meat goats only) - May 28, Boone County Fairgrounds, Albion Lively Livestock 4-H Club Sheep, Goat, & Swine Show June 3, York County Fairgrounds, York Hustler 4-H Progress Show, June 11, Cuming County Fairgrounds, West Point (Beef, Sheep, Swine, Goats) Platte County Swine Progress show, June 18 Dairy Cream of the Crop Dairy Cattle Show, June 3, Cuming County Fairgrounds, West Point Livestock Judging Winners Unlimited Livestock Judging Camp, June 6-8 or June 12-14, Lincoln, Reg. Due May 12 Nebraska Livestock Judging Classic, June 9, Buffalo Co. Fairgrounds, Kearney, Reg. Due June 7 PASE, June 26-27, Lincoln Reg. DUE by May 26 Horse Northeast Nebraska 4-H Horse Show, June 1, Homer (Reg. Due May 26) Northeast NE 4-H Barrel Racing Clinic (Brenda Sedlak), Wayne Co. Fairgrounds, June 2, (Reg. Open April 18) Northeast NE Horsemanship Clinic (Lexy Nuesch), Wayne Co. Fairgrounds, June 3, (Reg. Open April 18) Northeast NE Horsemanship Clinic (Lexy Nuesch), Wayne Co. Fairgrounds, June 4, (Reg. Open April 18) 4-H Horse Camp June 8-10 (Reg. due May 19), Fort Robinson State Park, Crawford If more information is needed about any of these events, please contact the Extension Office. Sincerely, Amy Amy Topp, Extension Educator 5

6 2017 Sunday Monday Tuesday Wednesday Thursday Friday Saturday 1 Clover Kid Meeting Reg. DUE Clover Kids Meeting, 9-10:15 AM & Teen Supremes, 10:15-11:00 AM Wayne County Courthouse 7 Paper Clover Fundraiser Ends 8 Regional Public Speaking & Interview Judging Contest Entries DUE 9 10 Teens as Teachers Webinar 6:30-7:30 p.m Level Testing Completed for District & State Horse Shows District & State Horse Show Entries & Horse ID s DUE Market Meat Goat Weigh-in, 5:30 PM, ID s DUE Sheep Weigh-in, 6 PM, ID s DUE Jr. Robotics & Robotic Summer Camp Registration Due to Dakota County (Wakefield site) Memorial Day Observed Extension Office Closed 30 Jr. Robotics Camp, 10 a.m.- Noon, Wakefield Robotic Summer Camp, 1-4 p.m., Wakefield Jr. Robotics & Robotic Summer Camp Registration Due to Dakota County (Laurel site) 24 Quality Assurance 4-H Building, 1 PM & 6:00 PM 4-H Council 31 Jr. Robotics Camp, 10 a.m.-noon, Wakefield Robotic Summer Camp, 1-4 p.m., Wakefield Quality Assurance Pierce County Courthouse, 1 PM & 6:00 PM 25 Regional Public Speaking & Interview Judging Contests Lifelong Learning Center, Norfolk Reg. DUE for Crochet, Pillowcase, Table Runner & Welding, Workshops & Dog Workouts June 1 Welding Workshop, Northeast Community College, 9 a.m. 4 p.m. Jr. Robotics Camp, 10 a.m.-noon, Wakefield Robotic Summer Camp, 1-4 p.m., Wakefield 26 LENRD Scholarship Apps DUE to LENRD PASE/Life Challenge Reg. DUE CWF payment Due 4-H T-shirt Orders Due Reg. DUE for Birdfeeder, Fairy Garden, & Photography Workshops & Horse Clinic 27 4h.unl.edu

7 JUNE CALENDAR 1 4-H T-shirt Orders DUE 1 CWF Payment DUE 1 Career Day-Exploratory Welding Workshop, Northeast Community College (Reg. Due May 25) 2 Easy Table Runner Workshop, Wayne Jr. /Sr. High School (Reg. Due May 25) 5 Pillowcase Workshop, Wayne Jr./Sr. High School (Reg. Due May 25) 5 Crochet Workshop, Wayne Co. Courthouse (Reg. Due May 25) 5, 13, 19, 27 Dog Workouts, Wayne Co. Fairgrounds (Reg. Due May 25) 5-7 Jr. Robotics Camp (10 a.m.-noon), Robotic Summer Camp (1-4 p.m.), Laurel (Reg. Due May H Horticulture Contest, Rundell Home (Reg. Due TBA) 8 Pre-District Horse Show Equine Etiquette Clinic, Wayne Co. Fairgrounds (Reg. Due June 1) 8 Movie Night, Wayne City Library Lawn 9 Fairy or Miniature Garden Workshop, Wayne Co. Fairgrounds (Reg. Due June 1) 9 Birdfeeder Workshop, Wayne Co. Fairgrounds (Reg. Due June 1) 12 Photography Basics Workshop, Wayne Co. Fairgrounds (Reg. Due June 1) 12 District Horse Show, Lexington (Entries Due May 12) 14 District Horse Show, Wayne (Entries Due May 12) 15 Mid-Year Enrollments DUE Note new date! 15 All ID s DUE 15 Ak-Sar-Ben & State Fair DNA Samples & Breeding Animal Nominations DUE 15 Quality Assurance Certificates DUE 16 Barn Quilt Workshop (Reg. Due June 9) 19 Acrylic Painting Workshop, Wayne Co. Fairgrounds (Reg. Due June 9) 19 Ponca Camp Counselor Training (Apps. Due June 9) Tractor Safety Training, Wayne Co. Fairgrounds (Reg. Due June 9) 20 Ponca Camp (Reg. Due June 9) 20 District Horse Show, Lincoln (Entries Due May 12) 21 Yeast Bread Workshop, Wayne Jr./Sr. High School (Reg. Due June 15) Jr. Robotics Camp (10 a.m.-noon), Robotic Summer Camp (1-4 p.m.), Concord (Reg. Due June Entomology Workshop, Ike s Lake (Reg. Due June 15) 22 Clover Kid Camp, Bressler Park (Reg. Due June 15) PASE/Life Challenge (Reg. Due May 26) 28 Multi-county Clover Kid Camp, Haskell Ag Lab, Concord (Reg. Due June 22) 30 Stars and Stripes Workshop, Wayne Co. Fairgrounds (Reg. Due June 22)

8 Ponca Day Camp Registration DUE By 5:00 p.m., June 9 Registration: Available from Extension Office or online at Thurston.unl.edu. $18/camper or adult. Make check payable to University Nebraska-Lincoln. Camper check in is from 8:45-9:15 a.m. and pick-up is 5:00-5:15 p.m. Ponca Day Camp is open to all youth ages 8-11 (birthdates ) from Cedar, Dakota, Dixon, Thurston, or Wayne Counties. Tuesday, June 20, :45 A.M. 5:00 P.M. Ponca State Park, East Shelter (located north of the Missouri National Recreational River Resource & Education Center.) Send registration form and check to: Nebraska Extension Dixon County Rd Concord, NE Camp Sessions include: Soil Discovery All About Owls Check It Out What s On Our Hike? STEMulate Your MIND Lunch & Snacks Swimming Camp Preparedness: Comfortable, outdoor clothes, & tennis shoes Swimming suit and towel Insect repellent and sun screen Label ALL Belongings Leave valuables & money at home. Special Note to Parents: Ponca State Park Regulation: To insure camper safety, parents are asked to drop off and pick up campers in the area for the east shelter. Adults will also need to sign in campers and sign out campers upon departure. A park entry sticker must be purchased to enter the park. A season sticker, good for all Nebraska State parks, is $31, or a one-day permit may be purchased for $6. Sorry, park staff will not make exceptions to this law for our camp. We encourage carpooling.

9 PONCA 4-H DAY CAMP REGISTRATION FORM One Camper Registration per sheet! Make check of $18.00 per camper payable to: University of Nebraska Lincoln Send completed form and check to: Nebraska Extension-Dixon County, Road, Concord NE by 5:00 p.m., June 9 NO REGISTRATIONS ACCEPTED AFTER JUNE 9! Please print or type Parent/Guardian will attend ($18.00 fee) Name Participant s First Name Middle Initial Last Name Mailing Address City ST Zip Code Phone Age Date of Birth Grade in School 4-H County Name Gender: Male Female address I give permission to use my child s name/photograph in publications, advertisements, 4-H web page or news articles pertaining to 4-H activities. Yes No EMERGENCY CONTACTS We must have two different contacts with both day and night phone numbers. Parent/Guardian Day Phone Night Phone Street Address City ST Zip Code Address If parent/guardian cannot be reached, contact: Parent/Guardian Day Phone Night Phone Street Address City ST Zip Code Address INSURANCE INFORMATION Is the 4-H participant covered by family medical/hospitalization insurance? Yes No As parent/guardian of the 4-H participant, I understand that health insurance coverage is the parent/guardian s responsibility. Medical Insurance Company Policy No. Name of Insured Relationship to participant Medical Care Provider-Name of Family Physician or Health Care Facility Phone CONDITIONS, RESTRICTIONS OR ALLERGIES (Please list all) Describe Condition, restriction or allergy and how to manage (attach additional pages if necessary) Medication allergies Allergies (food, latex, etc) Conditions (diabetic, asthma etc) Restrictions (ear plugs while swimming) - over -

10 HEALTH HISTORY INFORMATION Does the participant currently have or have had any of the following. Check yes or no to each question. Please explain any yes answers (noting the number of the question) in the space below or on an additional sheet of paper if necessary. Yes No Yes No 1. Had a recent injury, illness or infectious disease? 11. Have diabetes or hypoglycemia? 2. Have a chronic or recurring illness or condition? 12. Have asthma? 3. Been hospitalized/had surgery within the past 2 years? 13. Had Mononucleosis in the past 12 months? 4. Have frequent headaches? 14. Had seizures? 5. Had a head injury and/or been knocked unconscious? 15. Had frequent ear infections? 6. Has passed out, been dizzy and/or had chest pain during or after exercise? 16. Wear glasses, contacts or protective eyewear? 7. Had heart-related problems (high/low blood pressure, shortness of breath, murmurs, etc)? 17. Have an orthodontic appliance? 8. Had muscular/skeletal problems (arthritis, hernia, 18. If female, have an abnormal menstrual recent fractures, back/joint problems)? history? 9. Had stomach/intestinal problems (ulcers, jaundice, 19. Had emotional difficulties for which indigestion, diarrhea/constipation)? professional help was sought? 10. Have any skin problems (itching, rash, acne)? 20. Had an eating disorder? If yes, please give details (i.e. reactions, special instructions, special equipment, and procedures). Attach additional pages if necessary: Date of last physical exam: Date of last Tetanus immunization: Sign MEDICATIONS Medications must be given to the 4-H leader/staff in charge of the event at registration. Please list all prescription and non-prescription medications. All medications must be brought in the original container which identifies the medication s name, the dosage and frequency of administration and the prescribing physician (if applicable). Provide enough medication for the entire 4-H event. Medication No. 1 Dosage Route (eye, ear, oral) Specific times taken each day Reason for taking Medication No. 2 Dosage Route (eye, ear, oral) Specific times taken each day Reason for taking The following medication is taken during the school year, but is not taken now This person does not take medication on a regular basis If deemed necessary, I (parent/guardian) give permission to administer non-prescription medications in accordance with directions on the label for headaches, upset stomach, diarrhea, menstrual cramps and poison ivy. PARTICIPANT MAY BE RELEASED TO: Anyone listed on the health/registration form. Name (s) OR Extension Personnel 4-H PARTICIPATION AGREEMENT: With my Parent/Guardian, I have completed this form and will assume responsibility for taking my medication and for restricting any activities agreed upon and listed on this form. I will exercise good judgment in regard to my own health, safety and well-being while at 4-H events and activities. I have read the 4-H code of Conduct and agree to follow these expectations. Sign 4-H Participant Signature Date PERMISSION TO TREAT, PARTICIPATE AND RELEASE OF CLAIMS The waiver and release of liability was executed this day of, 20 by (Parent/Guardian) of (Address) City of County of State of, individually and as Parent/Guardian of in favor of the Board of Regents of the University of Nebraska (UNL). (referred to in this document as Participant). Officers, Employees, Instructors, Staff, agents, operators, successors, and assigns. Parent/Guardian hereafter known as Releasor, wishes the participant to participate in the 4-H event named on this document and participate in all activities except as noted on this form. 1. In consideration for the participation in 4-H camp and UNL Campus Recreation Activities, Releasor hereby RELEASES and covenants not-to-sue UNL or 4-H for any and all present and future claims resulting from ordinary negligence on the part of UNL or 4-H for property damage, personal injury, or wrongful death arising as a result of engaging in, using University facilities and equipment, or receiving instruction for 4-H camp and UNL Campus Recreation Activities or activities thereto, wherever, whenever, or however the same may occur. 2. Releasor hereby voluntarily waives any and all claims or actions resulting from ordinary negligence, both present and future, that may be made by Releasor s family, estate, personal representative, heirs, or assigns. Further, Releasor realizes that participation in 4-H camp and UNL Campus Recreation Activities involves certain risks and danger and is a vigorous activity involving severe respiratory and cardiovascular stress. 3. Releasor has hereby been made aware that participation in 4-H camp and UNL Campus Recreation Activities has the following non-exclusive list of certain risks which I accept: death; head, eye, neck and spinal injury resulting in complete or partial paralysis; brain damage; heart attack; blisters; cuts; lacerations; abrasions; concussions; contusions; strains; sprains; dislocations; fractures; cold and heat injuries; water immersion; drowning; lightning strikes; injury to bones, joints, muscles, internal organs; and environmental conditions. 4. In addition, I understand and accept the incidental risks of travel to and from the site of activity; participation at sites that may be remote from available medical assistance; and the possible reckless conduct of other participants. 5. In the event of a medical emergency, the 4-H camp or University of Nebraska or its representatives have my permission to take whatever measures they deem reasonable to render assistance and that I and/or my family will be financially responsible for any expense involved. 6. I have read and understand that this WAIVER is intended to be as broad and inclusive as permitted by the laws of the State of Nebraska and agree that if any part is held invalid, the remaining parts of this WAIVER AND RELEASE will continue in full force and effect as intended. I further agree that the venue for any legal proceeding shall be in the State of Nebraska. Parent/Guardian Signature Date

11 4-H Program Participant/Parent/Guardian Code of Conduct The primary goal of the 4-H Program is to help youth develop competency in their projects, confidence in themselves and others, connections to their community and sound character. Actions by persons (Parents, and 4-Her s) involved with the 4-H Program will be consistent with the six core ethical values comprising good character: trustworthiness, respect, responsibility, caring, fairness and citizenship. As a 4-H Participant/Parent/Guardian I will: Treat all people and property with respect, courtesy, consideration and compassion. Avoid and prevent putdowns, insults, name calling, swearing and other language or nonverbal conduct likely to offend, hurt or set a bad example. Keep informed about 4-H program policies and projects and read materials pertaining to the county 4-H program. Teach and model kindness and compassion for others. Recognize that all people have skills and talents which can be used to help others and improve the community. Teach and foster teamwork and discourage selfishness. Practice fair-mindedness by being open to ideas, suggestions and opinions of others. I will make all reasonable efforts to assure equal access to participation for all youth and adults regardless of race, creed, color, sex, national origin or disability. Decisions will be made fairly and treat all individuals and families with impartiality. Obey laws and rules as an obligation of being a good citizen. I accept responsibility for the proper treatment and care for other youth and adults, the program facilities and/or equipment. Demonstrate the responsible treatment of animals and stewardship of the environment. Not use alcohol or illegal substances (or be under the influence) while working with or participating in any part of the 4-H Program. Provide a safe environment for all parties involved in 4-H. I will protect those involved from sexual harassment, physical force, verbal or mental abuse, neglect, or other harmful behaviors. Sign Sign 4-H Parents, Guardian and/or Youth who do not abide by the above code of conduct, may receive the following consequences: Be asked to explain actions to the 4-H Council. Be dismissed from an event at own expense. Further disciplinary action determined by the 4-H Council, which may include: o restriction from contacting 4-H families, volunteers, donors, and/or sponsors pertaining to any 4-H matter o becoming ineligible to attend any further 4-H activities o family may become ineligible to participate in the County 4-H Program Reimburse the proper entity for any property damage or for liability resulting from inappropriate actions. In the case of vandalism, guilty party may be required to reimburse 4-H and/or the facility. Participant Date Parent(s)/Guardian(s) Date

12 510 N Pearl Street, Suite C / Wayne, NE / / FAX wayne-county@unl.edu / Website: Facebook: H Educational Events To register for the 2017 Summer Workshops please call the Extension Office at or fill out the google form. In the google form, please select all workshops that your 4Her would like to attend. One form should be filled out per family. If you have any problems, please contact the office. To access the form, please visit: Payment will be accepted at the workshop. Each event must have five 4-Hers registered to hold. QUALITY ASSURANCE DATE & TIME: MAY 24, 1:00 P.M. AND 6:00 P.M. LOCATION: PIERCE COUNTY COURTHOUSE DATE & TIME: MAY 31, 1:00 P.M. AND 6:00 P.M. COST: NO CHARGE RECOMMENDED: FOR YOUTH ENROLLED IN ANIMAL PROJECTS, EXCEPT CAT, DOG, COMPANION ANIMAL, OR HORSE JR. ROBOTICS CAMP/ (SR.) ROBOT SUMMER CAMP LOCATION: GARDENER PUBLIC LIBRARY, WAKEFIELD DATE & TIME: MAY 30, 31, & JUNE 1, JR: 10:00 AM NOON SR: 1:00 PM 4:00 PM REGISTRATION DUE: TO DAKOTA COUNTY MAY 23 LOCATION: LAUREL COMMUNITY LEARNING CENTER, LAUREL DATE & TIME: JUNE 5, 6, & 7, JR: 10:00 AM NOON SR: 1:00 PM 4:00 PM REGISTRATION DUE: TO DAKOTA COUNTY MAY 30 LOCATION: NEBRASKA EXTENSION IN DIXON COUNTY, CONCORD DATE & TIME: JUNE 21, 22, & 23, JR: 10:00 AM NOON SR: 1:00 PM 4:00 PM REGISTRATION: TO DAKOTA COUNTY JUNE 14 ADDITIONAL INFORMATION: REGISTRATION FORMS ARE AVAILABLE ON THE WAYNE COUNTY WEBSITE. JR CAMPS ARE FOR YOUTH WHO HAVE COMPLETED GRADES 1-3 AND SR CAMPS ARE FOR YOUTH WHO HAVE COMPLETED GRADES 4-8 CAREER DAY EXPLORATORY WELDING LOCATION: NORTHEAST COMMUNITY COLLEGE NORFOLK DATE & TIME: JUNE 1, 9 AM 4 PM RECOMMENDED: YOUTH MUST BE 12 YEARS OF AGE TO PARTICIPATE. YOUTH WHO ARE ENROLLED IN 4-H WELDING. AN ADULT TO ACCOMPANY YOU. COST: $10 REGISTRATION DUE: MAY 25 DESCRIPTION: JOHN KNAPP, NORTHEAST COMMUNITY COLLEGE INSTRUCTOR WILL BE TEACHING YOUTH THE WELDING PROCESS USING THE GMAW/MIG WELDING PROCESS. YOUTH WILL COMPLETE THE WELDING JOINTS EXHIBIT FOR THE FAIR; DISPLAYING ONE BUTT, ONE LAP, AND ONE FILLET WELD. MATERIALS NEEDED: YOUTH MUST WEAR BOOTS, JEANS, AND 100% COTTON CLOTHING. PLEASE BRING SAFETY GLASSES, ALONG WITH PPE INCLUDING A HELMET, JACKET, AND GLOVES. IF YOU DO NOT HAVE SAFETY EQUIPMENT, PLEASE INDICATE THAT WHEN YOU SIGN UP. PLEASE BRING $10 FOR LUNCH, THERE WILL BE A BREAK TO EAT AT HAWKS LANDING. ADDITIONAL INFORMATION: THE WORKSHOP WILL BE HELD IN WELLER BUILDING ROOM 105 ALONG WITH THE WELDING LAB ROOMS 101 & 103. TABLE RUNNER WORKSHOP LOCATION: FCS ROOM/ WAYNE JR. SR. HIGH SCHOOL DATE & TIME: JUNE 2, 9:00 AM NOON RECOMMENDED: YOUTH IN DESIGN DECISIONS COST: $5 REGISTRATION DUE: MAY 25 DESCRIPTION: THIS IS FOR YOUTH WHO ARE ENROLLED IN DESIGN DECISIONS. EXHIBITED AS AN ACCESSORY- TEXTILE 2D MATERIALS NEEDED: PLEASE BRING 10 INCH PIECE OF THE 44/45 INCH WIDTH FABRIC AND 20 INCH PIECE OF THE 44/45 INCH WIDTH FABRIC. ALL FABRIC IS 100% COTTON THAT IS RANDOMLY PRINTED, NOT A FABRIC WITH A SPECIFIC PATTER OR DIRECTION. OPTIONAL: TWO COORDINATING BUTTONS TO EMBELLISH THE TABLE RUNNER. A SPOOL OF COORDINATING THREAD. A MAT AND ROTARY CUTTER. CROCHET WORKSHOP LOCATION: MEETING ROOM, WAYNE COUNTY COURTHOUSE DATE & TIME: JUNE 5, 9:00 AM 11:00 AM RECOMMENDED: FOR YOUTH ENROLLED IN THE CROCHET PROJECT COST: $3 REGISTRATION DUE: MAY 25 DESCRIPTION: LEARN BASIC CROCHET STITCHES & MAKE A SCRUNCHIE HAIR TIE MATERIALS NEEDED: CROCHET HOOK SIZE J OR K AND APPROXIMATELY 2 OZ. OF WORSTED WT YARN PILLOWCASE WORKSHOP LOCATION: FCS ROOM/ WAYNE JR. SR. HIGH SCHOOL DATE & TIME: JUNE 5, 12:30 PM 3:30 PM RECOMMENDED: YOUTH IN STEAM CLOTHING 1, PILLOWCASE COST: $5 REGISTRATION DUE: MAY 25 DESCRIPTION: MAGICAL PILLOWCASE THAT CAN BE EXHIBITED UNDER THE PILLOWCASE CLASS C IN STEAM 1. MATERIALS NEEDED: 3/4 YARD MAIN FABRIC, 1/3 YARD CONTRAST FABRIC, COORDINATING THREAD.100% COTTON FABRIC THAT IS RANDOMLY PRINTED, NOT A FABRIC WITH A SPECIFIC PATTERN OR DIRECTION, THIS WAY WE DON T HAVE TO WORRY ABOUT MATCHING THE PATTERN AT THE SIDE SEAMS. DOG WORKOUTS LOCATION: WAYNE COUNTY FAIRGROUNDS DATE & TIME: STARTING JUNE 5, 13, 19, 27, JULY 3, 11, 17, 6:30 PM RECOMMENDED: FOR YOUTH ENROLLED IN THE DOG PROJECT COST: NO CHARGE REGISTRATION DUE: MAY 25 DESCRIPTION: JACE, MARISSA, & JENNIFER MUNSELL WILL DEMONSTRATE OBEDIENCE AND SHOWMANSHIP SKILLS. DOGS ARE WELCOME PLEASE MAKE SURE YOUR DOG IS CURRENT ON RABIES, DISTEMPER, HEPATITIS, AND PARVO VACCINATIONS. MATERIALS NEEDED: BRING YOUR COLLARS AND LEADS. OVER

13 PRE-DISTRICT HORSE SHOW EQUINE ETIQUETTE CLINIC TRAINER: JOSIE KETELSEN WITH KETELSEN TRAINING, NORFOLK, NE LOCATION: HORSE AREA, WAYNE COUNTY FAIRGROUNDS DATE & TIME: JUNE 8, 9:00 AM NOON COST: $15 PER PERSON OR $25 FOR A FAMILY REGISTRATION DUE: JUNE 1 DESCRIPTION: (VISUAL CLINIC NOT RIDING CLINIC) THE CLINIC TOPICS WILL INCLUDE: SHOWMANSHIP- THE BASICS AND PATTERN WORK, HORSEMANSHIP- BASICS AND PATTERN WORK, NUTRITION- HORSE EVALUATIONS AND GRAIN & FORAGE OPTIONS, RANCH HORSE PLEASURE BASICS AND PATTERN WORK. FAIRY OR MINIATURE GARDEN WORKSHOP DATE & TIME: JUNE 9, 9:00 10:30 AM RECOMMENDED: HOUSEPLANTS PROJECT COST: $5 IF YOU BRING YOUR OWN SUCCULENTS, $15 IF YOU CHOOSE 3 OF OUR SUCCULENTS REGISTRATION DUE: JUNE 1 DESCRIPTION: CREATE A FAIRY GARDEN TAUGHT BY GRACE & MARY HEITHOLD MATERIALS PROVIDED: POTTING SOIL AND SUCCULENT PLANTS IF YOU CHOOSE 3 FROM THE EXTENSION OFFICE MATERIALS NEEDED: 1 POT NO BIGGER THAN 12 DIAMETER (INSIDE MEASUREMENT) PREFERABLE WITH A DRAINAGE HOLE, 3 TO 5 SUCCULENTS AND/OR MINIATURE OR SMALL SLOW GROWING HOUSEPLANTS (KEEP TAGS WITH IDENTIFICATION OF PLANTS USED), IMAGINATIVE THEME, AND MINIATURE ACCESSORIES TO GO WITH YOUR THEME (FOUND INEXPENSIVELY AT ANTIQUE AND THRIFT STORES). IT S ALSO FUN TO MAKE YOUR OWN USING TWIGS (BENCHES, LADDERS, & CHAIRS), SHELLS, MARBLES, ETC. BIRDFEEDER WORKSHOP DATE & TIME: JUNE 9, 10:30 AM 12:30 PM RECOMMENDED: YOUTH ENROLLED IN CONSERVATION AND WILDLIFE COST: $10 REGISTRATION DUE: JUNE 1 DESCRIPTION: YOUTH WILL MAKE A BIRDFEEDER USING RECYCLED VEGETABLE CANS AND WOOD. MATERIALS PROVIDED: BOARDS, NAILS, SCREWS, AND PAINT MATERIALS NEEDED: 5 VEGETABLE CANS PHOTOGRAPHY BASICS WORKSHOP DATE & TIME: JUNE 12, 9:30 AM 11:30 AM RECOMMENDED: FOR YOUTH IN UNIT 1 AND UNIT 2 PHOTOGRAPHY COST: $3 REGISTRATION DEADLINE: JUNE 1 DESCRIPTION: HAVE YOU EVER WONDERED WHAT MAKES A GREAT PICTURE? COME TO THIS WORKSHOP TO LEARN ABOUT PHOTOGRAPHY BASICS INCLUDING LIGHTING, COMPOSURE, & BACKGROUNDS. LEARN WHAT JUDGES ARE LOOKING FOR AND DO SOME FUN PRACTICING! BRING A FULLY CHARGED CAMERA OR DEVICE FOR PRACTICING. BARN QUILT WORKSHOP DATE & TIME: JUNE 16, 9:00 AM 4:00 PM RECOMMENDED: YOUTH IN QUILT QUEST COST: $10 REGISTRATION DEADLINE: JUNE 9 DESCRIPTION: YOUTH WILL BE ABLE TO COMPLETE A 2 FT X 2 FT BARN QUILT MATERIALS PROVIDED: THE PRIMED BOARD WILL BE SUPPLIED, AS WELL AS 3 DIFFERENT DESIGNS YOUTH CAN CHOOSE FROM MATERIALS NEEDED: PLEASE BRING THREE 8 OZ. PAINTS (TWO MEDIUM COLORS OF DIFFERENT SHADES, AND A DARK COLOR COLORS ARE PARTICIPANT S CHOICE) ACRYLIC PAINTING WORKSHOP DATE & TIME: JUNE 19. 9:00 AM NOON RECOMMENDED: 4-HERS BE ENROLLED IN PORTFOLIO PATHWAYS COST: $30/ PAINTER OR $42 IF A FRAME IS NEEDED REGISTRATION DUE: JUNE 9 DESCRIPTION: LEARN PAINTING TECHNIQUES AND CREATE A PROJECT THAT CAN BE EXHIBITED AS AN ORIGINAL ACRYLIC PAINTING. MATERIALS NEEDED: ALL SUPPLIES PROVIDED YEAST BREAD WORKSHOP LOCATION: FCS ROOM/ WAYNE JR. SR. HIGH SCHOOL DATE & TIME: JUNE 21, 9:30 AM 2:00 PM RECOMMENDED: YOUTH ENROLLED IN FAST FOODS, YOU RE THE CHEF, OR FOODWORKS COST: $7 REGISTRATION DUE: JUNE 15 DESCRIPTION: THERE IS NOTHING LIKE THE SMELL OF FRESH BAKED BREAD. IN THIS WORKSHOP, WE WILL BE MAKING A LOAF OF BREAD IN A BREAD MACHINE, IN N A MIXER WITH DOUGH HOOKS, AND A LOAF YOU KNEAD BY HAND. WE WILL BE WORKING WITH DOUGH TO MAKE A VARIETY OF SHAPES. THIS WORKSHOP INCLUDES PIZZA FOR LUNCH. ENTOMOLOGY WORKSHOP LOCATION: IKE S LAKE, WILL GIVE DIRECTIONS OUT TO YOUTH SIGNED UP DATE & TIME: JUNE 22, 9:15 AM NOON RECOMMENDED: FOR YOUTH ENROLLED IN ENTOMOLOGY COST: $10 REGISTRATION DUE: JUNE 15, LIMITED TO 10 PARTICIPANTS DESCRIPTION: LEARN HOW TO COLLECT, PRESERVE, AND IDENTIFY BASIC KINDS OF INSECTS AND THEIR LIFECYCLES. MATERIALS PROVIDED: INSECT PINS, DISPLAY BOX, LABELING MATERIALS, AND BASIC ID GUIDE. MATERIALS NEEDED: HAT, SUNSCREEN, INSECT REPELLENT AND A WIDE MOUTH GLASS JAR WITH STRAIGHT SIDES LIKE A PICKLE JAR. (NO CANNING JARS) CLOVER KID CAMPS LOCATION: BRESSLER PARK, WAYNE DATE & TIME: JUNE 22, 9:00 AM 11:30 AM REGISTRATION DUE: JUNE 15 COST: $10 DESCRIPTION: YOUTH WILL LEARN ABOUT THE 4-H PROGRAM AND COMPLETE PROJECTS THEY CAN BRING TO THE WAYNE COUNTY FAIR. LOCATION: HASKELL AG LAB, CONCORD DATE & TIME: JUNE 28, 9:00 AM 11:30 AM REGISTRATION DUE: JUNE 22 TO WAYNE COUNTY COST: $8 RECOMMENDED: YOUTH AGES 5-7 YEARS OLD BY STARS N STRIPES WORKSHOP DATE & TIME: JUNE 30, 9:00 AM 4:00 PM RECOMMENDED: 4-HERS ENROLLED IN DESIGN DECISIONS PROJECT, THE PROJECT CAN BE ENTERED IN THE ACCESSORY RECYCLED/UPCYCLED OR ACCESSORY OUTDOOR LIVING CLASSES. COST: $7 REGISTRATION DUE: JUNE 22 DESCRIPTION: LEARN FAUX PAINTING TECHNIQUES! TURN AN OLD, UNWANTED PIECE OF FURNITURE INTO SOMETHING NEW AND USABLE AGAIN! MATERIALS NEEDED: OLD CHAIR, BENCH, STOOL, CREAM CAN, SHELF, BUCKET, TRUNK OR OTHER ARTICLE YOU WOULD LIKE TO MAKE INTO A PATRIOTIC TREASURE! PERHAPS YOU SIMPLY WANT TO MAKE A PLAIN PIECE OF WOOD INTO A COAT RACK FOR YOUR ROOM. PLEASE ALSO BRING THREE DISPOSABLE PLASTIC CONTAINERS WITH LIDS, RAGS, AND YOUR LUNCH. WEAR OLD CLOTHES. SIMPLE STEP STOOL WORKSHOP COST: $15 DATE & TIME: JULY 11, 9:00 AM 11:00 AM DESCRIPTION: MAKE A SIMPLE TWO STEP STOOL RECOMMENDED: FOR 4-HERS ENROLLED IN UNIT2 WOODWORK (MAKING THE CUT) MATERIALS NEEDED: PLEASE BRING AN ELECTRIC DRILL AND BIT IF YOU HAVE ONE. ALL REGISTRATION DUE: JULY 6 OTHER MATERIALS WILL BE PROVIDED.