Kentucky 4-H Camp High Ropes Training 2013 Registration Form

Name: County: City, State, Zip: Office Phone: Cell Phone: Home Phone: E-mail: Date: Address:

I have participated in a high ropes course sometime in the past: ________YES ________NO I request campground lodging _______YES _______NO Dates for the training: West KY 4-H Camp, May 9 & 10

Time: Begins 8:30 a.m. Central Time daily and ends when all activities have been completed on the last day. (Cannot give a specific time.) Registration Fee for the training: $175.00 - includes all instructional materials. Campground lodging is available for free with prior notice. Meals are NOT included in the registration fee. *Please make check payable to: Kentucky 4-H Foundation Who: Extension personnel and volunteers (18 years of age and older) Class size: Maximum of 12 participants per class How to register: Send this registration form and check for registration fee to: State 4-H Youth Development Office 212 Scovell Hall Lexington, KY 40546-0064 ATTN: Donna Fox dfox@uky.edu *Please Note: Your reservation for this training will not be confirmed until the registration form and registration fee are received at the State 4-H Office.