For Individuals with Disabilities Who Require Auxiliary Aids Or Services for Program

2015 STATE 4-H ROUNDUP YOUTH REGISTRATION FORM

DUE TO ARRIVE BY 5:00 P.M. JUNE 19, 2015

Return ONE form per youth and ONE check per county, TO: Ag Conference Services, 430 Student Union, Stillwater, OK 74078.

Completed forms will be worked in order they are received.

PRINT or TYPE

Name Gender

Home Address

City Zip Phone

Email Address

Emergency Contact Name and Phone #:

How old were you on Jan 1, 2015? ______Grade County District

Are you a First Timer? YES or NO Are you a Final Timer? YES or NO

PRE-REGISTRATION IS REQUIRED FOR ALL WORKSHOPS AND COMPETITIVE EVENTS!

Optional Information:

This information will be used for reporting Civil Rights and Affirmative Action compliance.

With which group(s) do you identify?

_____ African American _____ Asian/Pacific Islander _____ Caucasian _____ Hispanic

_____ Native American

Do you have affiliation with any Native American tribes? (Please circle one)

YES NO If yes, please indicate:

For individuals with disabilities who require auxiliary aids or services for program participation, please identify the accommodation/service needed when submitting this form. Advance notice is necessary for effective service provision; it may not be possible to provide some aids and services with late notice. Reasonable effort will be made to accommodate individuals who request auxiliary aids or services.

Oklahoma state university, in compliance with title vi and vii of the civil rights act of 1964, executive order 11246 as amended, title ix of the education amendments of 1972, Americans with disabilities act of 1990, and other federal laws and regulations, does not discriminate on the basis of race, color, national origin, sex, age, religion, disability, or status as a veteran in any of its policies, practices or procedures. This includes but is not limited to admissions, employment, financial aid, and educational service

Name County:

WEDNESDAY

COMPETITVE EVENTS – SEE GUIDELINES ON WEBSITE
Only one competitive event from this section may be entered.
Communication Contest - Speech, Illustrated Pres. or PowerPoint presentation should have been previously presented at a county or district contest or for a local organization to enter public speaking at Roundup
To enter mark an X in front of the event and list the category number (Note: The codes are listed in the communication guidelines on the Roundup Website).
______IL. Illustrated Presentation Category #______(1-5) If team, list partner______
______SP. Speech Category # ______(6-10) (Individuals Only)
______PP. PowerPoint Category #______(11-15) (Individuals Only)
______PE. Photography Exhibition Category______(A-G)
______GE. Graphic Design Exhibition Category______(A-D)
______Vocal Contest (Additional form required. See requirements)
______FCS Skill-A-Thon Workshop/Contest (Check eligibility requirements on Roundup page. Individuals and county teams of 3-4 members who have competed in/or qualified for National Contest are not eligible to participate.)
______ATV Safety Contest – Must have ATV Safety Institute RiderCourse Certification Card. CERTIFICATION FORM REQUIRED. If team, list partners______
AFTERNOON WORKSHOPS
If you do not choose a competitive event above , you will attend two one hour workshops (A & B)
OR one two hour workshop (C). Rank your choices (1-10) within this entire section
ONE HOUR WORKSHOPS / _____A22: Mason Jar Terrariums
_____A01/B01: Leg Bandaging and Physical Exams for Horses / _____A23: Knot, knot, knot!
_____A02/B02: Distracted Driving / _____A24: Designing Landscapes
_____A03/B03: Chalk It Up! / _____A25: SECRET tips for HANDSHAKES
_____A04/B04: Medical School 101 / _____A26: Violence in Dating Relationships
_____A05/B05: Family and Consumer Sciences – Making a Difference / _____B27: 45 Different Ways to Tie a Tie!
_____A06/B06: Pride in our Flag / _____B28: Introduction to the Vet Science Project
_____A07/B07: Zoo Design / _____B29: How to Start a 4-H Project Club in Your County
_____A08/B08: Get In The Game with 4-H Recreation / _____B30: Avatars, 3D Body Scanners, Virtual Dressing Rooms…
_____A09/B09: What’s Stopping You? / _____B31: Smoothies for an Afternoon on the Go!
_____A10/B10: Video Storytelling / _____B32: The Science Behind Wind And Solar Power
_____A11/B11: Go International: Building Your Legacy at Home and Abroad – RECOMMENDED FOR YOUTH 16 AND OVER / _____B33: Piggy Backing Leadership with Livestock Projects
_____A12/B12: Legal Legacy: Careers in the Legal Field / _____B34: More Than a Record Book
_____A13/B13: CASNR: Expanding Minds, Inspiring Purpose / _____B35: Pecan Grafting
_____A14: Rise and Shine! Quick and Healthy Breakfast Ideas / _____B36: Make Or Save Money in Your Livestock Operation
_____A15: The Great Launch Challenge / _____B37: Building Your Leadership
_____A16: Leadership and Career Exploration through Aviation, Health and Education / _____B38: Soil and Water Conservation through Healthy Soils
_____A17: An Apple a Day / _____B39: Cracking the Oklahoma Fire Safety Problem
_____A18: Toy Box Leadership / TWO HOUR WORKSHOPS
_____A19: Tour The Boren Vet Med Teaching Hospital / _____C01: FARRM Game
_____A20: Tree Identification / _____C02: This Into That! Eco-Friendly Clothing Redesign
_____A21: Is Fire Fighting in Your Future? / _____C03: Taking Robots to the Next Level

Name County:

THURSDAY

COMPETITIVE EVENTS – SEE GUIDELINES ON WEBSITE
Only one competitive event from this section may be entered. Delegates not entering a competitive event will participate in the workshop sessions listed below.
1:30 p.m. – 4:00 p.m.
_____ G01: Tractor Operator Contest (limit 3 intermediates and 3 seniors per county in this event) CERTIFICATION FORM REQUIRED
_____ G02: Land Judging Workshop and Computer Contest (NO TEAM REQUIRED)
_____ G03: Clover Quiz Bowl (TEAM REQUIRED)
_____ G04: Livestock Quiz Bowl (TEAM REQUIRED)
_____ G05: Fashion Revue Contest (Requires Garment –See Contest Guidelines). Additional form required
_____ G06/D01: Intermediate Job Readiness Contest– Ages 13-14 (limit 3 per county in this event). Youth will attend Workshop D01 and then need to indicate choices for the “E” workshop session. Additional form required
_____ G07: Advanced Job Readiness Contest: Ages 15 and over (limit 2 per county in this event). Additional form required
_____ G08: Food Showdown: Participants must be District winners. If your district has NOT had its qualifying event, do NOT sign up for this event. You will be added by your District Coordinator later.
AFTERNOON WORKSHOPS
If you do not choose a competitive event, you will attend two one-hour workshops (D & E)
OR one two-hour workshop (F)
Rank your choices (1-10) within this entire section
ONE HOUR WORKSHOPS / _____D21: Swine Center Tour
_____D01/E01: Get Set, Get Ready, Get A Job! / _____D22: Team Building Activities for the Digital Age
_____D02/E02: Fun Fitness / _____D23: Mason Jar Terrariums
_____D03/E03: Weather and Oklahoma Mesonet / _____D24: Polish Your Public Speaking
_____D04/E04: Colorful Foods / _____E25: 3D Printing
_____D05/E05: DNA in My Food?? The Making of a Smoothie / _____E26: Zumba
_____D06/E06: Adding Impact to Your Speeches / _____E27: A Healthy (and Tasty!) Alternative to Ice Cream
_____D07/E07: Project Runway / _____E28: An Apple a Day
_____D08/E08: Life After High School: Careers in Family and Consumer Sciences! / _____E29: Livestock Judging 101: Reason Preparation
_____D09/E09: Exploring Digital Storytelling / _____E30: Your Bag of Tricks
_____D10 /E10: ATV Safety / _____E31: Hall of Fame Blue Award Group, National Congress Delegates and Record Book Scholarship Project Finalists report to Gallagher for honor night assembly practice at 3:30 p.m.
_____D11/E11: Disc Dog Demo and Fun with Fido
_____D12/E12: Tour Gallagher
_____D13/E13: Western Legacy / TWO HOUR WORKSHOPS
_____D14: Designing Landscapes / _____F01: Kicker Subwoofers Tour
_____D15: How to Beat the Heat: Iced Coffee / _____F02: FARRM Game
_____D16: Yoga / _____F03: Tour the OSU Art Museum
_____D17: Toy Box Leadership / _____F04: Wearable Electronics
_____D18: Tie Dye with a Twist! / _____F05: Taking Robots to the Next Level
_____D19: Fruits and Vegetables: Dips and Dippers! / _____F06: Awareness Self Defense (Females ONLY)
_____D20: Tree Identification / _____F07: 4-H Has Talent Rehearsal (Pre-Selected)

2015 Oklahoma 4-H Roundup

Place Bonding

Participants Information Sheet

To: Roundup Youth Delegate, Adult Volunteer, and Extension Educators

We are inviting you to take short survey about your experience on the OSU campus. Please read this letter and ask any questions you may have before taking this survey.

The study: This study will help find out if coming to 4-H events, such as Roundup, affect the way you feel about the OSU campus. You will be asked to complete a survey which will take about 10 minutes to complete.

Risks and benefits: There are no known risks in taking this survey. There are also no direct benefits from taking this survey.

Participation is voluntary: You do not have to participate even if your parents gave your permission. There is no penalty for not taking the survey and you are free to quit at any time. Your decision to fill out the survey or not to fill it out will not change your relationship with Oklahoma State University or with your school or 4-H club. If you decide to take part, you are free to skip any questions, or stop at any time.

Confidentiality: Your answers will be kept private. Anything written about this study will only discuss group results. Your answers will be kept safe and only researchers and those supervising them will be able to see the records.

Contacts : Stephen Beck

205 4-H Youth Development

Stillwater, OK 74078

If you have questions about your rights as a research volunteer, you may contact Dr. Hugh Crethar, IRB Chair, 223 Scott Hall, Stillwater, OK 74078, 405-744-3377 or .

Steve Beck

Oklahoma 4-H/Youth Development

Oklahoma State University

2015 Oklahoma 4-H Roundup

Place Bonding

Parental/Guardian Information Sheet

As a 4-H Roundup Delegate, we are inviting your child to participate in short survey about place belonging as part of their experience on the OSU campus. We ask that you read this information and ask any questions you may have before allowing your child to take part in this survey.

The study: The purpose of this study is to find out how participating in 4-H events at OSU such as Roundup effect the development of feelings of attachment and belonging to the OSU campus. Your child will be asked to complete a questionnaire which will take approximately 10 minutes to complete.

Risks and benefits: There are no known risks associated with this project which are greater than those ordinarily encountered in daily life. There are no direct benefits or tangible rewards to you or your child if he or she takes part in the study.

Voluntary Participation: Your child’s participation in this survey is completely voluntary. Your child may skip any questions he or she doesn't feel comfortable answering. Your decision whether or not to allow your child to take part will not affect your current or future relationship with Oklahoma State University or with your child’s school or 4-H club. If you decide to allow your child to take part, your child is free to not do the survey, skip any questions, or stop at any time.

Confidentiality: The records of this survey will be kept private. Any written results will discuss group findings and will not include information that will identify your child. Research records will be stored securely and only researchers and individuals responsible for research oversight will have access to the records. It is possible that the consent process and data collection will be observed by research oversight staff responsible for safeguarding the rights and wellbeing of people who participate in research.

Participant Rights: I understand that my child’s participation is voluntary, that there is no penalty for refusal to participate, and that I am free to withdraw my permission at any time, without penalty.