SMALL ANIMAL ENTRY FORM ONLY

Size: px

Start display at page:

Download "SMALL ANIMAL ENTRY FORM ONLY"

Dora Paul
5 years ago
Views:

SMALL ANIMAL ENTRY FORM ONLY Exhibitor Phone Number: Exhibitor Name: Veterinarian Name: Veterinarian Phone Number: Owner of Animal if different: Owner s Phone Number: Please indicate the species for

1 SMALL ANIMAL ENTRY FORM ONLY Exhibitor Phone Number: Exhibitor Name: Veterinarian Name: Veterinarian Phone Number: Owner of Animal if different: Owner s Phone Number: Please indicate the species for which the entry form is being used ONE SPECIES PER FORM Dept Section Class Breed Variety Sex D.O.B. or (Showroom class for rabbits Jr. Int. Sr) N/A Tattoo or Tag Number N/A For Office use Animal Emergency Sign Off Entered into Winfair on/by Exhibitor will automatically be entered into herdsmanship for the animal areas in which they participate. All Fair Premium checks must be cashed by January 1 of this program year or they will be donated back to the Orleans County Cornell Cooperative Extension. Youth and volunteers will adhere to the 4-H Code of Conduct during the event. Failure to do so may result in loss of premiums. Decisions regarding exhibitor conduct will be the responsibility of fair officials and OCCCE staff. I understand and agree to abide by the above statements and the 4-H Code of Conduct during the fair. Youth Signature Parent Signature

LARGE ANIMAL ENTRY FORM ONLY Exhibitor Phone Number: Exhibitor Name: Veterinarian Name: Veterinarian Phone Number: Owner of Animal if different: Owner s Phone Number: Please indicate the species for

2 LARGE ANIMAL ENTRY FORM ONLY Exhibitor Phone Number: Exhibitor Name: Veterinarian Name: Veterinarian Phone Number: Owner of Animal if different: Owner s Phone Number: Please indicate the species for which the entry form is being used ONE SPECIES PER FORM Dept Section Class Name Breed Sex D.O.B. Tattoo or Tag Number O= Owned Or N= Not Owned N/A N/A N/A N/A For Office use Animal Emergency Sign Off Entered into Winfair on/by Exhibitor will automatically be entered into herdsmanship for the animal areas in which they participate. All Fair Premium checks must be cashed by January 1 of this program year or they will be donated back to the Orleans County Cornell Cooperative Extension. Youth and volunteers will adhere to the 4-H Code of Conduct during the event. Failure to do so may result in loss of premiums. Decisions regarding exhibitor conduct will be the responsibility of fair officials and OCCCE staff. I understand and agree to abide by the above statements and the 4-H Code of Conduct during the fair. Please indicate your primary showmanship species here: Youth Signature Parent Signature

3 Submit one copy only, unless animals being exhibited are owned by multiple people. In case of an emergency, 4-H Staff/Superintendents will attempt to contact you and the owner first, followed by the veterinarian listed. If they cannot reach you, the owner, or the veterinarian, for the health and safety of your animal, as well as all people and animals on the grounds, 4-H Staff/Superintendents will contact a veterinarian. 1. I, on behalf of myself or my child (or children), acknowledge that Cornell Cooperative Extension of Orleans County, its officers, directors, employees, agents and volunteers and the members of the Orleans County 4-H Fair Committee, have absolutely no responsibility whatsoever for the safety and well-being of the animal or animals, and I/we leave the animals on the fairgrounds entirely at our own risk. 2. I/we release and discharge from and waive any claim or liability against Cornell Cooperative Extension of Orleans County, its officers, directors, employees, agents, and volunteers and the members of the Orleans County 4-H Fair Committee for any injury, including death, or damage to the animal(s) regardless of any cause whatsoever for said injury, damage, or death. This release shall be binding on us and any of our legal representatives or assigns. 3. In the event of any attempt by any other party or parties to assert any type of claim or demand against Cornell Cooperative Extension of Orleans County, its officers, directors, employees, agents and volunteers, and the members of the Orleans County 4-H Fair Committee, I/we shall indemnify, defend, and hold harmless each and all of them from said claim or demand. OWNER/EXHIBITOR WILL BE RESPONSIBLE FOR ALL FEES INCURRED. By signing this form, and as a condition of leaving the above listed animals at the Orleans County 4-H Fair, we have read and agree to all the terms and conditions herein and those listed on this form. EXHIBITOR S PARENT/GUARDIAN: SIGNATURE PRINT NAME ANIMAL OWNER: SIGNATURE PRINT NAME WITNESS: SIGNATURE PRINT NAME

4 FAIR CODE OF CONDUCT AND RULES Submit one copy per youth Must be signed by exhibitor and parent/guardian and returned with Advance Entry Form or Trolley Building Entry Form FAIR CODE OF CONDUCT All fair participants shall, at all times, act with a mature and morally responsible attitude, recognizing the basic rules of society and the common rights of others. All fair participants shall designate a primary superintendent and report to him or her in the event of an emergency. My primary superintendent is:. All fair participants will abide by all special rules and regulations of Orleans County Cornell Cooperative Extension, the barns, and/or sections in which they participate. Interpretation and application of rules and regulations is the responsibility of the superintendents. Their decisions will be final. All fair participants will cash Fair Premium checks by January 1 of the following year. Any checks not cashed by January 1 of the following year will be donated back to Orleans County Cornell Cooperative Extension. I,, understand and agree to abide by the above code of conduct. Exhibitor signature Parent or guardian signature RULES AND REGULATIONS Project a positive 4-H image to the public! Be courteous to and respectful of people and animals Do not participate in horseplay or unauthorized activities Clean-up after yourself Do not use abusive language or profanity Keep wash racks and manure areas neat Avoid wasting water Do not run in the barn Avoid loud music and noise Do not use fireworks Be clothed in proper apparel (4-H appropriate) Wear closed-toe shoes when working with animals and footwear at all times

5 QUALITY ASSURANCE PLEDGE Orleans County 4-H Livestock Raisers Commitment to Excellence Submit one copy per youth with Advance Entry Form All 4-H members engaged in meat animal production activities are expected to review and do the best job that they can do to understand and adhere to the following practices. As a 4-H member, I am learning the best ways to house, feed, manage, and care for animals. I am also learning about vaccination practices and health care procedures I can follow to protect my animals from becoming sick or injured. I will inspect facilities for things like cleanliness, animal comfort, and safe methods of animal handling and restraint, and make the appropriate changes to improve the animals comfort and safety. I will work with my veterinarian and follow my veterinarian s advice and recommendations. I agree that I will strictly adhere to label directions when using any over the counter medications I understand that many medications and treatments have withdrawal times. Common medications or treatments include de-worming medicines, vaccinations or shots given to prevent diseases, and antibiotics used to treat diseases. I will choose grooming products that I know are safe for humans and animals. I will read product labels and avoid products that may be harmful to my animal or me, such as methylene chloride and toluene. (Examples of products to avoid are leather polishes, nail polishes, aerosol paints, water based cleaners, and water based adhesives.) I will learn about and follow state and federal animal identification regulations. I will learn how to prepare livestock for market by calculating proper withdrawal times for legal medications and treatments. I will be honest in reporting my knowledge about treatments before my animals are prepared for shows, sales, market, or slaughter. I will do my part to ensure a safe food supply by sending animals that are clean, dry, disease free, and medication free to market. I will be kind and considerate in my relationships and will strive to do others no harm. I am aware that my actions and decisions affect others. If I do not follow these practices, I could be harming myself. I could be harming others. I could be harming the food supply. I could be asked to withdraw from participation in future 4-H livestock activities. My signature means I have read and will practice the voluntary Quality Assurance Pledge. 4-Her Signature Parent/Guardian Signature Date Revised by Jennifer Wagester 4/7/2014 (Adapted from the NYS 4-H Animal Science Quality Assurance Pledge Advisory Panel May 2002/Revised 2006/Revised 2013)

6 CLOTHING REVUE & MANNEQUIN MODELING CONSUMER EDUCATION REPORT ON PURCHASED GARMENT Required for Department 19 - Clothing & Textiles: Section E Classes 25 & 26, Section F Classes 28 & 29. Submit this completed report with the Advance Entry Form by July 1. Name: Age (As January 1 of this year): Garment Purchased: Directions: Answer each question completely and please print neatly. 1. Why was the garment purchased? 2. How does it fit into your wardrobe? 3. Describe fabric structure (woven, knit, etc.), fiber content (cotton, polyester, etc.), and special care if any: 4. What accessories did you select to wear with your purchase? 5. Where was it purchased? Cost: 6. To the best of your ability, itemize what it would cost to make the garment: If on sale original cost before discount: Pattern: Notations: Other materials: Fabric: Labor: Total Estimated cost:

7 YOUTH LEADER - Entry Form Submit with advance entries on July 1 Name Telephone Birthdate Address Club Name Years in 4-H 4-H Age Grade Have you served as a Youth Leader, Junior Superintendent, or Youth Evaluator at 4-H events before? Yes No If yes: How many years? In what areas: What officer or other leadership positions have you held in 4-H? Projects Years of Participation (list # of years in each, for example: Dairy 3, Horse 2, Clothing 5, Public Presentations 7) # Years Project # Years Project Military Mailgram Public Presentations 5-Star (Horse) Clothing Revue Conservation Field Days Orleans County 4-H Fair Holiday Faire Other: Participation in Events (list # of years in each) Senior Council Leaders Fundraiser (plant, candy bar) Senior Council Stand HPDC Horse Show or 3-Day Clinic Dairy Bowl Horse PDC (HPDC) Officer Training Course Other:

8 ORLEANS COUNTY 4-H FAIR TROLLEY BUILDING CLUB EXHIBIT DISPLAY REQUEST FORM Form due by July 1 Complete this form only if your club will be using table space to display all Trolley Building entries from members together in one area of the building. Club Name: Leader(s): Phone Number(s): Cell Number(s) (# to reach you during fair): (s): Anticipated Number of Exhibitors: # of Exhibits: Number of tables needed: 6 foot table(s) 8 foot table(s) Designated Person(s) for Saturday and Monday Set-up Phone By signing below, I agree that I have read and understand the guidelines and procedures for displaying exhibits in a club exhibit area. I agree to follow these guidelines and give feedback during and after the Fair to help assess the procedures for future years. Club Leader: Date:

2019 Erie County 4-H Project Record Book

2019 Erie County 4-H Project Record Book Name: Age: (as of 1-1-19) 21 South Grove Street, East Aurora, NY 14052 716-652-5400 Helping You Put Knowledge to Work Cornell Cooperative Extension is an employer