4-H Livestock Clinic

REGISTRATION FORM

Due April 9, 2010

Fee: $3.00 for Each Attendee (Adult or Member)  Register up to 4-Participants per form.  Copies may be made, if needed.

Attendee (1) ___________________   ___________________

Species Track Check One

Beef Sheep

Goats Swine

Attendee (2) ___________________   ___________________

Species Track Check One

Beef Sheep

Goats Swine

Attendee (3) ___________________   ___________________

Species Track Check One

Beef Sheep

Goats Swine

Attendee (4) ___________________   ___________________

Species Track Check One

Beef Sheep

Goats Swine

Club Contact Information:

Club Name: _______________________________

Club Leader: ______________________________

Leader’s Phone: ___________________________

Make Checks Payable to:

Crawford County 4-H Fund

Mail Form and registration Fee to:

Crawford County Cooperative Extension

Livestock Clinic

13400 Dunham Road, Suite A

Meadville, PA  16335