2016 STATE 4-H ROUNDUP YOUTH REGISTRATION FORM
DUE TO ARRIVE BY 5:00 P.M. JUNE 15, 2016
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, 2016? ______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 WEBSITEOnly 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-B)
______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 / _____B13: Make A Flower/Plant Press
_____A01/B01: 4-H Fun While Learning / _____B14: Devore – Creating See-Through Patterned Fabrics
_____A02/B02: Distracted Driving / _____B15: Fuel Your Body! Fuel Your Brain!
_____A03/B03: Whitetail Bucks / _____B16: The Science Behind Wind And Solar Power
_____A04/B04: Pride In Our Flag / _____B17: Light Your Torch Of Leadership
_____A05/B05: 4-H Taters / _____B18: The Science Of Processing Food
_____A06/B06: Life Is Short, Play More! / _____B19: Sheep And Goat Showmanship
_____A07/B07: What Are We Doing For Share The Fun? / _____B20: IT’s A Security Thing
_____A08/B08: Hunter Safety
_____A09/B09: 3, 2, 1...Blast Off! / TWO HOUR WORKSHOPS
_____A10: Meatless Monday! / _____C01: The FARRM Game Challenge
_____A11: How To Prepare For 4-H Trips And Shows / _____C02: 3D Printing Basics
_____A12: Values Auction / _____C03: Crops Judging 101
_____A13: Hunger Hits Home / _____C04: Wearable Electronics
_____A14: Tour The Boren Vet Med Teaching Hospital / _____C05: Kicker Subwoofers Tour
_____A15: Avatars, 3D Body Scanners, Virtual Dressing Rooms… / _____C06: Livestock Judging Market Steer Evaluation
_____A16: Guess What? / _____C07: Designing Landscapes
_____A17: Leadership After 4-H / _____C08: Horse Project
_____A18: Conserving Water in Landscape / _____C09: Cutthroat Clover Café
_____B10: Pecans: Sumptuous, Simple and Satisfying / _____C10: Leading Leadership
_____B11: The Crepe Escape: Sweet And Savory / _____C11: WeConnect: Exploring Global Citizenship
_____B12: Introduction To The Vet Science Project / _____C12: Veterinary Surgical Team
Name County:
THURSDAY
COMPETITIVE EVENTS – SEE GUIDELINES ON WEBSITEOnly 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/D12: Intermediate Job Readiness Contest– Ages 13-14 (limit 3 per county in this event). Youth will attend Workshop D12 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 / _____D20: Livestock Judging 101: Reasons Prep
_____D01/E01: ATV Safety / _____D21: Strong Bones For A Strong Future
_____D02/E02: Strawberry DNA Extraction / _____D22: Data Analytics With Pediatric Diabetes
_____D03/E03: Mesonet In Your Hand / _____E12: #Foodlablelyfe
_____D04/E04: Ignite Your Fcs Career! / _____E13: Zumba
_____D05/E05: Getting Started With Podcasting / _____E14: Hydration Can Be Super Without Being Super Sweet!
_____D06/E06: Medical School 101 / _____E15: Values Auction
_____D07/E07: Wildlife Crime Stoppers / _____E16: Farm To Pizza
_____D08/E08: Braiding Your Way / _____E17: Hall of Fame Blue Award Group, Key Club Inductees, National Congress Delegates and Record Book Scholarship Project Finalists report to Gallagher for honor night assembly practice at 3:30 p.m.
_____D09/E09: Powerful Public Speaking
_____D10 /E10: Food for Thought: Setting Your Place / TWO HOUR WORKSHOPS
_____D11/E11: #DiscDogsRock!! / _____F01: The Farrm Game Challenge
_____D12: Because One Day, You’ll Graduate / _____F02: Crops Judging 101
_____D13: Beyond The Range / _____F03: This Into That! Eco-Friendly Clothing Redesign
_____D14: Snack Attack! / _____F04: We Want YOU To Be A FIRE Fighter
_____D15: Yoga / _____F05: Write Your Own Song!
_____D16: Does This Mean They “LIKE” Me? / _____F06: Self Defense Awareness (Females Only)
_____D17: Swine Center Tour / _____F07: Horse Project
_____D18: Tour The Boren Vet Med Teaching Hospital / _____F08: Knot, Knot, Knot!
_____D19: The Science Behind Wind And Solar Power / _____F09: 4-H Has Talent Rehearsal (Pre-Selected)