$2.50 FAIR ENTRYFEE DATE RECEIVED:______
2016 CAMBRIA COUNTY 4-HDAIRY GOAT ENTRY/REGISTRATION FORM
FOR
CAMBRIA COUNTY EXTENSION OFFICE AND THE CAMBRIA COUNTY FAIR
CAMBRIA COUNTY EXTENSION OFFICE
NO LATER THAN JUNE 15, 2016 BY 4:00 P.M.
Dairy Goat must be owned and in your possession by June 1st.
ONE (1) ANIMAL PER FORM
*REGISTRATIONS SUBMITTED AFTER DEADLINE DATE WILL NOT BE ACCEPTED*
EXHIBITOR NAME: ______PHONE: ______
STREET/BOX: ______
CITY/STATE/ZIP: ______
BIRTHDATE: ______4-H AGE AS OF JANUARY 1ST : ______
4-H CLUB NAME: ______
PARENT/GUARDIAN NAME(S): ______
DAIRY GOATINFORMATION:
ANIMAL SCRAPIE EAR TAG ID/TATTOO#______TATTOO#______
ANIMAL SEX: DOE_____ WETHERS_____ ANIMAL’S DATE OF BIRTH______
Alpine_____ LaMancia_____ Nubian_____ Pygmy_____ Saanen_____ Recorded Grades_____ OTHER______
AS OF SEPTEMBER 4, 2016
- DOE KID, UNDER 5 MONTHS_____
- DOE KID, 5 MONTHS OLD AND UNDER 1 YEAR_____
5. DOE, 1 YEAR OLD AND UNDER 2 – NOT IN MILK_____
8. DOE, 1 YEAR OLD AND UNDER 2 – IN MILK_____
9. DOE, 2 YEARS OLD AND UNDER 3_____
10. DOE 3 YEARS OLD AND OVER_____
14. WETHERS (All Ages)_____
15. DAM & DAUGHTER, ANY AGE AND OWNED BY SAME FAMILY (Limit 1 Entry)_____*
16. GET OF SIRE, 3 ANIMALS, AND MUST BE OWNED BY SAME FAMILY_____*
* Animal Scrapie Ear Tag ID/Tattoo#______Tattoo#______AnimalSex: Doe_____ Wether_____
* Animal Scrapie Ear Tag ID/Tattoo#______Tattoo#______AnimalSex: Doe_____ Wether_____
* Animal Scrapie Ear Tag ID/Tattoo#______Tattoo#______AnimalSex: Doe_____ Wether_____
IS ANIMAL HOUSED AT THE ABOVE ADDRESS: YES____ NO____ IF NO, PLEASE INCLUDE FULL ADDRESS WHERE ANIMAL IS HOUSED:
______
TWO (2) LEADER SIGNATURES ARE REQUIRED TO VERIFY EAR TAG/TATTOO NUMBERS
LEADER SIGNATURE: ______
LEADER SIGNATURE: ______
PARENT AND 4-Her MUST SIGN THE FOLLOWING PAGE OF THIS FORM
2016 CAMBRIA COUNTY FAIR ENTRY FORM
DEPARTMENT 10 – 4-HDAIRY GOAT ENTRY FORM
DEADLINE – JUNE 15, 2016 – 4:00 P.M. – CAMBRIA COUNTY EXTENSION OFFICE
ENTRIES WILL NOT BE ACCCEPTED WITHOUT FEE ($2.50 FAIR ENTRY FEE PER LIVESTOCK HEAD)
LATE ENTRIES WILL NOT BE ACCEPTED
PLEASE PRINT EXHIBITOR NAME: ______
BY SIGNING THIS FORM I AGREE TO ABIDE BY THE FOLLOWING:
- A PENALTY OF $25.00 PER ANIMAL WILL BE CHARGED TO THE OWNER OF EACH ANIMAL ENTERED BUT NOTEXHIBITED AT THE FAIR. ENTRIES THAT ARE CANCELLED ON OR BEFORE AUGUST 15, 2016, MUST BE OF WRITTENNOTIFICATION AND WILL NOT BE ASSESSED THE $25.00 PENALTY. IN EXTREME OR UNUSUAL CIRCUMSTANCES AN APPEAL OFTHE ASSESSMENT OF THE PENALTY WILL BE CONSIDERED BY THE CAMBRIA COUNTY FAIR.
- THE GENERAL/LIVESTOCK REGULATIONS SET FORTH BY THE CAMBRIA COUNTY FAIR. (SEE CAMBRIA COUNTY FAIR WEBSITE FOR GENERAL/LIVESTOCK RULES AND REGULATIONS FOR 4-H EXHIBITORS AT FAIR.) cambriacofair.com
- ALL 4-H PROJECT BOOK REQUIREMENTS, INCLUDING BUT NOT LIMITED TO, CARING AND WORKING WITH MY PROJECT ANIMAL ON A REGULAR BASIS, REGULARLY ATTENDING CLUB MEETINGS AND COMPLETING PROJECT RECORDS.
- I ACCEPT SOLE RESPONSIBILITY FOR ANY LOSS, INJURY, OR DAMAGE DONE OR OCCASIONED BY OR ARISING FROM ANY EXHIBIT ENTERED BY MYSELF AND SHALL INDEMNIFY AND HOLD HARMLESS THE CAMBRIA COUNTY FAIR AGAINST SUCH LOSS, INJURY, OR DAMAGE.
- ALLOW THE FAIR OFFICE TO PUBLISH PHOTOS OF MYSELF ON THEIR WEBSITE AND IN ANY ADVERTISING USED SOLELY FOR FAIR. PLEASE CHECK IF WE CANNOT PUBLISH PHOTOS. NO______
- I AGREE TO ABIDE BY THE CODE OF SHOW RING ETHICS AND I UNDERSTAND THAT ALL JUDGE DECISIONS ARE FINAL.
- I ATTEST AND AFFIRM THAT A “VETERINARY-CLIENT-PATIENT RELATIONSHIP” – AS THAT PHRASE IS DEFINED IN THE ANIMAL EXHIBITION SANITATION LAW FOUND AT 3 Pa. C.S.A.§ 2501 et seq. AND ANY AMENDMENTS THERETO - EXISTS WITH REGARD TO ANY ANIIMALS I WILL BE EXHIBITING. PLEASE PRINT NAME AND ADDRESS OF DOCTOR OF VETERINARY MEDICINE MAKING VETERINARY MEDICAL JUDGEMENTS REGARDING THE HEALTH OF THE ANIMAL.
VETERINARY
NAME/ADDRESS______
ONLY(1) ONE ANIMAL PER FORM.
EXHIBITORS MUST BE PRESENT AND HAVE CHARGE OF THEIR ANIMALS AT ALL TIMES. See cambriacounty fair.com for details
10 / 607 / 62 / GOOD HOUSEKEEPING
10 / 607 / 63 / STALL DECORATIONS
10 / STOCKMAN
10 / SHOWMAN
EXHIBITOR SIGNATURE: ______DATE: ______
PARENT/GUARDIAN SIGNATURE:______DATE: ______
ALL REGISTRATION FORMS MUST BE TAKEN TO THE CAMBRIA COUNTY EXTENSION OFFICE WHO WILL THEN FORWARD THE FAIR REGISTRATION ON TO THE CAMBRIA COUNTY FAIR OFFICE. SEPARATE FAIR FORMS WILL NOT BE REQUIRED.
EXHIBITOR NAME:______
ATTACHPICTURES OF BOTH LEFT AND RIGHT SIDES OF THE ANIMAL.
LEFT SIDE PICTURERIGHT SIDE PICTURE
GOOD LUCK WITH YOUR PROJECT ANIMAL
REVISED NOVEMBER 2015
PENN STATE IS COMMITTED TO AFFIRMATIVE ACTION, EQUAL OPPORTUNITY, AND THE DIVERSITY OF ITS WORKFORCE