CSR Winter Camp 2015 (PDF | 444KB)

Transcription

CSR Winter Camp 2015 (PDF | 444KB)
4-H Winter Camp will run from 7:00 p.m. on Friday, February 27
through 11:00 a.m. on Sunday, March 1 at the Northern Virginia
4-H Education Center in Front Royal, Virginia.
**Campers: All boys and girls (9 to 14 years
of age as of 9/30/15) are welcome.**
**Teen Leaders must have past experience as a CIT
or a Teen Counselor at a 4-H camp. We do not
accept new CITs at CSR 4-H Winter Camp.**
There will be an Emergency Medical Technician on staff during
the weekend. Any medicine brought to camp, must be in
the original container with directions for dispensing.
In case of bad weather, call the Shenandoah Extension Office at
540/459-6140. If the weekend is cancelled, it will NOT be
rescheduled, due to unavailability of the 4-H Center, and full
refunds may take 30 days.
If you have any questions, feel free to contact:
Cristy Mosley, 4-H Agent, at 540/727-3435
If you are a person with a disability and desire assistance or accommodation,
please notify Cristy Mosley, Culpeper Extension Office at 540/727-3435
during business hours of 8:00 a.m. and 5:00 p.m. by February 10, 2015
www.ext.vt.edu
Virginia Cooperative Extension programs and employment are open to all, regardless of race,
color, national origin, sex, religion, age, disability, political beliefs, sexual orientation, genetic
information, marital, family, or veteran status, or any other basis protected by law. An equal
opportunity/affirmative action employer. Issued in furtherance of Cooperative Extension work,
Virginia Polytechnic Institute and State University, Virginia State University, and the U.S.
Department of Agriculture cooperating. Edwin J. Jones, Director, Virginia Cooperative
Extension, Virginia Tech, Blacksburg; Jewel E. Hairston, Administrator,
1890 Extension Program, Virginia State, Petersburg
Culpeper-Shenandoah
Rappahannock
2015
4-H Winter Camp
February 27 - March 1, 2015
4-H Center in Front Royal
2015 CULPEPER-SHENANDOAHRAPPAHANNOCK
4-H WINTER CAMP REGISTRATION
Please check:
TEEN
Choose which activities you would prefer to attend:
Please rank your workshop selections from 1—10
With 1 being your top pick.
You will be assigned to 3 classes.
CAMPER
Name ________________________________ Culpeper County
___
Make-up, Nails & Hair
__________________________________________________________
___
Video Production
Phone ______________________
___
Cooking Class
___
Decorating for the Dance
E-mail ________________________________
___
Arts & Crafts
Choice of one roommate: ______________________________________
___
Karaoke
Do you prefer to be contacted by email or phone? _________________
___
Rocketry
___
Scrapbooking
___
Science Fun
Address ___________________________________________________
Male ___ Female ___
Date of Birth _____________________ Age _________
Parent/Guardian Name _______________________________________
Are you already enrolled in 4-H for 2014-15? _______
If so, name of club?_________________________________________
If not, you’ll be required to complete enrollment, health history, media
release, and code-of conduct forms.
Have you been to 4-H Camp before? _____________
If so, when? __________________________________________
REGISTRATION COST:
CAMPER: $100
TEEN: $80
Return this form with the payment to:
VCE-Culpeper County
101 S. West Street
Culpeper, Virginia 22701
Make checks payable to: Treasurer, Virginia Tech– Culpeper
Please note there is a returned check fee of $50.
Registration Deadline is February 10, 2015
There are a limited number of spaces available, so register early.
Workshops will be assigned on a first-come, first-served basis.