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| ABOUT 4-H | VOLUNTEERS |
For a printable version of this document, click here
INTENT TO PARTICIPATE FORM
MAINE 4-H CANINE TEAM
EASTERN STATES EXPOSITION
(Please print all information below)
It is my intention to try out for the 2009 Eastern States Exposition Dog Program. I intend to: (check one)
____Exhibit My Dog _____ Exhibit a Leased Dog
____ Attend as a Steward with no Dog
I am enrolled as a 4-H member in the Dog Project in_____________________ county and have been a participant in this project for years. I am years old as of December 31, 2008. (Youth must be between 12 and 18 years of age to participate.)
___________________________________________
(Name)
(Mailing Address)
_______________________________
(Phone Number)
_________________________________________
(Email Address)
This form indicates your intent to participate in the Eastern States Exposition 4‑H Dog Program in the current year as a representative of Maine. This form must be completed and returned by the deadline to be eligible to try out for the Maine 4‑H ESE Canine Team in the current year. However, this form alone does not enroll the member on the 2009 Maine 4‑H ESE Canine Team. All requirements as stated on the Maine 4-H Dog Program website must be completed and/or fulfilled completely. I understand that I may be asked to fund raise and/or pay a portion of the costs incurred to transport my project dog or myself to ESE. I also understand if I make the team, that I am representing Maine and 4-H and will conduct myself accordingly.
________________________________ ________________________________
4-H Member’s Signature Parent or Guardian
________________________________ ________________________________
Project Leader *4-H Educator’s Signature*
*County Educator verifies that 4-Her was enrolled by December 31 of the current 4-H year.*
RETURN BY May 1, 2009 to:
Donna Flint – UMCE
21 Bradeen St., Ste 302
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