4-H Interest Form

Canyon County 4-H Interest Form

Complete this form if you are new to 4-H in Canyon County and would like more information about the 4-H program. The information you provide on this form will allow us to better serve you by allowing us to research some options for your family before we contact you; you will be contacted within 2-4 business days.
Parent's Name *

First Name Last Name
Mailing Address (Street) *
City *
State *
Zip code *
Primary Phone Number *
Email address *
Number of Children Interested in 4-H *
Youth # 1 Name *

First Name Last Name
Youth # 1 Gender *
Youth # 1 Date of Birth *

Month Day Year
Youth # 2 Name (if applicable)

First Name Last Name
Youth # 2 Gender (if applicable)
Youth # 2 Date of Birth (if applicable)

Month Day Year
Youth # 3 Name (if applicable)

First Name Last Name
Youth # 3 Gender (if applicable)
Youth # 3 Date of Birth (if applicable)

Month Day Year
Youth # 4 Name (if applicable)

First Name Last Name
Youth # 4 Gender (if applicable)
Youth # 4 Date of Birth (if applicable)

Month Day Year
Youth # 5 Name (if applicable)

First Name Last Name
Youth # 5 Gender (if applicable)
Youth # 5 Date of Birth (if applicable)

Month Day Year
Areas of Interest *

4-H for 5-7 year olds- "Cloverbuds" Small Animals (cat, dog, rabbit, etc) Livestock (pig, sheep, cow, goat, etc) Horse (members ages 8+ only) Visual & Tactile Arts (photography, ceramics, leathercraft, etc) Performing Arts (theater, cowboy poetry, etc) Foods (cooking, baking, cake decorating, etc) Healthy Living (first aid, gardening, etc) Outdoors (hiking, bicycle, fishing, etc) Personal Development, Leadership, Citizenship, etc Science (aerospace, geology, veterinary science, etc) Technology (computers, robotics, engines, etc) Shooting Sports (Archery, Rifle, Shotgun, pistol, etc)
I would like to learn more about *

Enrolling my child(ren) in a 4-H Club 4-H Day Camps 4-H Overnight Camps Special activities for 4-H Teens Becoming a certified 4-H Volunteer Starting a new 4-H Club
Anything else you'd like to tell us?
Should be Empty:

Canyon County 4-H Interest Form