Redwood 4H Registration 2017/18

** Online registration needs to be completed at 4hOnline before forms and fees

will be accepted. Please bring a print of the email from 4hOnline or a screen print
of your 4hOnline member list showing 2017/18 pending.
** Only fully complete packets will be accepted. Redwood Registration Form with
all forms and fees together as one packet. Packets may be turned it at the Sept. and
Oct. club meetings or by mail: Redwood 4-H, 1651 Apple Drive, Concord, CA 94518.
The packet can be checked and signed off upon receipt if mailed but will be returned if
incomplete. Receipts for mailed-in packets will be available at club meetings not mailed
back.

Full names of youths enrolling: ____________________________________________

_____________________________________________________________________

Full names of adult leaders enrolling: _______________________________________

Requirement: Verification Signature:

1. Online Enrollment complete for all listed above: ________________

2. Complete and signed youth and parent/guardian agreement forms

received: ________________

3. Pay fees (youth/ adult leader):

Total youth fee = $71.00 x ____ = $______________
Total adult fee = $16.00 x ____ = $______________
TOTAL DUE = $______________
Name of payer _____________________________
check#___________ Cash ____

___ Fee waiver request form completed in lieu of pymt. ________________

4. Yearbook purchase (optional):

_____ book(s) x $10 = $______________ _________________

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Detach and keep the bottom portion

Registration has been fully completed by _____________________________________

Name of registering parent/guardian
For ________youths and ________ adult leaders
Youth last name if different from registering parent/guardian ________________
Verified by:_________________________(circle: treasurer, enrollment coordinator, club leader)