2017TREMPEALEAU COUNTY
4-H HORSE CAMP
WHAT: A special camp offering instruction by knowledgeable trainers, English and Western horsemanship, showmanship, horse safety, and much more! Learn from experience, examine new ideas and techniques, make new friends, and have FUN!
WHO: Open to any member of the Trempealeau County 4-H Horse Project, FFA and surrounding counties. Registration deadline is May 1, 2017. Camp is limited to 40 youth – registration is not complete until payment in full has been made.
WHEN/WHERE: June 15th, 16th, 17that the Galesville Fairgrounds. Check in between Noon and 5pm on Thursday, June 15th. Camp concludes at 5pm on Saturday, June 17th. Horses may be dropped off Wednesdaynight, however, there will NOT be anyone at the fairgrounds to supervise them overnight. You are responsible for their well-being. Stalls are on a first come basis – STALLS MAY NOT BE RESERVED AHEAD OF TIME.
COST: $100 per camper, including t-shirt, and meals. Extra t-shirts are $15. Adult meals for the weekendare an additional $15. There is a discounted rate for those Trempealeau County youth who have turned in five or more sponsorships. Daily rate is $40. Payment must accompany registration form! Trempealeau County youth will be asked to bring an item for meals. Please bring enough for 75 people.
A $20 STALL DEPOSIT IS TO BE SENT WITH YOUR REGISTRAION FEE. THIS CHECK WILL BE RETURNEDIF YOUR STALL IS CLEAN PRIOR TO LEAVING. Please send a separate check for the stall deposit.
WHAT TO BRING: Negative Coggins test original paperwork, plus a copy. Remember, the new test run from calendar date to calendar date. Premises IDnumber (This is your farm number that your horse is kept at). Proper tack (clean and in good condition). Straw for bedding may be used, shavings preferred. Water buckets, manure fork, and rain gear as needed. Please familiarize your horse with new gear prior to camp. SEI approved safety helmet. Camping gear, sun block, hard soled boots or shoes (1/2" heal preferred). An adult must accompany campers sleeping in trailers. No exceptions!
Photographer may be available on Friday to take pictures of riders/horses. Please come dressed appropriately if you wish to have your photo taken.
- Horses must be manageable and in good health. Campers are required to follow 4-H policy rules and will be in their tents by 10:30 PM. No visitors in tents past 10:30 PM!
- Food and monetary donations for meals are gladly accepted.
- Arm bands will be provided for all paid campers. Parents and other family members may purchase armbands if they are eating at horse camp and did not pre-purchase their meals.
- Parents are encouraged to camp and participate along with their children.
- There will be a $10 electrical fee for those using electricity. Please make checks payable to Trempealeau County Ag Society.
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Registration forms due May 1, 2017 for planning.
Name: / Age: / 4-H Club:Address: / Phone No. 1: / e-mail:
Phone No. 2:
Emergency Contact:
(Name) / (Phone) / (Relationship to Youth)
Horse Camp participant will: Stay in tent Stay with parent(s) on grounds Go home at night
Other ______
I will bring _____ horse(s) –limit of two horses per camper.
I am a Beginner Intermediate Advanced in the horse project Horseless
Number and size of T-shirts (adult sizes only): _____ Small _____ Medium _____ Large _____ XL _____ XXL
I have read the 4-H policy on behavior and will abide by the guidelines.
Parent Signature: / Youth Signature:Please make checks payable to "Trempealeau County 4-H Horse Project".Send payment and registration to: Connie Guza,W26995Doris Guza Road, Independence, WI 54747. Call (715) 985-3185or text 715-797-3235 if you have any questions or
Please be sure to complete a health form available on the Trempealeau County 4-H Horse Project Website.
Thank you for participating with our Trempealeau County 4-H Horse Camp! We appreciate it very much!! :) See ya there!!
Trempealeau County 4-H Hold Harmless Agreement
The undersigned on behalf of him/herself, his/her heirs, successors or assigns plus the undersigned parent, parents or legal guardians of the Trempealeau County 4-H member listed on this registration form, hereby specifically agrees to hold Trempealeau County, its agent, representatives, volunteers, 4-H members, employees, and elected officials harmless from any and all liability for injury, death or property damage which may occur as a direct or indirect result of participation in the Trempealeau County 4-H Program. This release is binding on the participant, his/her heirs, successors or assigns of the same.
Trempealeau County 4-H Camp Expectation Agreement
As a condition of participation in 4-H program trips, activities, and events you agree to be bound by the terms of this Agreement. Terms of the Agreement shall apply while you are participation in activities or attending events because you are a 4-H member.
4-H member must:
1.Behave in ways acceptable to others.
2.Use good judgment in selecting clothing appropriate to occasion.
3.Be responsible for own property.
4.Respect public and personal property.
5.Be financially liable and responsible for any damage to public or personal property.
6.Abide by quiet hours and curfew times established by chaperone or sponsoring organizations.
7.Behave in accordance with applicable federal, state and municipal laws.
8.Abide by any additional expectations established for a particular event.
Trempealeau County 4-H Members and other participants, will be appropriately disciplined when there is reasonable proof of the following:
1.Possession or use of illegal drugs, chemicals, tobacco, or alcoholic beverage.
2.Theft, misuse, or abuse of public or personal property.
3.Sexual misconduct.
4.Breaking curfew or disturbing the peace.
5.Unauthorized use of vehicles during an activity or event.
6.Illegal or unsafe use or possession of non-prescription drugs.
7.Use of prescription medication other than as prescribed by physician (Chaperones must be informed of the need to take any such medication).
8.Use of language found to be objectionable by others.
Trempealeau County 4-H members, their families and other participants understand the leaders/chaperones role to be:
1.To serve as an advocate for the 4-H Members.
2.To maintain regular contact with members to monitor health, attitude and problem situations
3.To be aware of all prescription medication; but not to dispense medication
4.To make appropriate decision in emergency situations to enhance the health and well-being of the members
5.To have responsibility for determining the occurrence of inappropriate behavior and taking appropriate actions, which may include:
a.Counseling with involved member(s).
b.Taking disciplinary actions at the time of occurrence, not to include physical punishment.
c.Informing parents and UW-Extension personnel of misbehavior if leader/chaperone feels the situation warrants notification.
d.Deciding to remove member from the program and send his/her home early at the member family's expense. Representatives removed from the program in such a manner may be required to relinquish all funds provided towards event, may result in restricted opportunity to participate in future 4-H related activities for the involved member(s), and may be required to appear before the Trempealeau County Leaders' Association Executive Board.
As a 4-H member, I have read and understand the Trempealeau County 4-H Annual Behavioral Expectation Agreement and the Trempealeau County Hold Harmless Agreement accept each and agree to abide by all.
4-H Member’s Signature: / Date:I, as parent/guardian, have read and understand the Trempealeau County 4-H Annual Behavioral Expectation Agreement and the Trempealeau County Hold Harmless Agreement, accept each, and agree to be bound by all. Parent’s signature
Parent’s Signature: / Date: