King County 4-H

Enrollments for 2016/2017

DUE TO THE 4-H OFFICE BY DECEMBER 15, 2016

CLUB NAME_____________________________________________________

RETURNING ENROLLMENTS	NO. AMOUNT

Members (must be between the ages of 5 and 18 as of October 1, 2016)	X $10.00 or $11.00 (horse or ATV members)	=

WAIVER REQUESTS

Members	X $1.00 or $2.00 (horse or ATV members for insurance	=

Total ________	$____________

(Submit one club check or money order)

Made out to King County 4-H Association

List members for whom the enclosed fees are being paid. Enrollment is not complete until fees received.

List youth who are enrolling in King County 4-H for the very first time. No enrollment fees required 2016/17

Submit to King County 4-H Association 1000 Oakesdale SW Suite 150 Renton, WA 98057

New enrollments throughout the remainder of the 4-H year should be turned into the 4-H office within two weeks of the new member joining your club.