WSU Extension > San Juan County WSU Extension > 4-H Program > 4-H Leaders’ Council > San Juan County Leaders Council Policy > 4-H Horse Replacement Request Form 4-H Horse Replacement Request Form 4-H Horse Replacement Request In cases of severe injury, or death, or unsafe behavior of the project horse, a replacement may be considered. (Refer to the Pacific Northwest 4-H Horse Contest Guide pg.5 ). Please complete the following information and submit to the Extension Office within 48 hours of the veterinary examine. If you any questions, please contact the 4-H Program Coordinator at (360) 378-4414. Name of 4-H Member(Required) First Last Member's Phone Number(Required)Member's Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code 4-H Club(Required) Name of Horse to be replaced(Required) Name of substitute horse(Required) Select all that apply(Required) Horse Certificate Submitted* Non-Project Horse** * A successful substitution of the secondary horse may show at the county 4-H level, but will not be allowed to exhibit at state fair. ** An approved non-project horse may show at the county level in 4-H Classes and receive Danish ribbons, but is ineligible for Grand or Reserve 4-H ribbons, 4-H Premium points, and 4-H showmanship or 4-H equitation awards, and will not be allowed to exhibit at the State 4-H Fair. Name of Examining Veterinary Doctor(Required) First Last Date of Exam(Required) Month Day Year Reason for Replacement(Required) Illness Injury Death Attach the letter from the examining veterinary describing the illness, severe injury or confirming death. Member Signature(Required) I agreeBy clicking "I Agree," you acknowledge that you are the individual submitting this form and that the content of the form is accurate and correct to the best of your knowledge. You understand and agree that this completed form constitutes the entire agreement between you and San Juan County 4-H. You intend to sign this agreement electronically, and your click serves as your legally binding electronic signature.Parent Signature(Required) I agreeBy clicking "I Agree," you acknowledge that your child or dependent is the individual submitting this form and that the content of the form is accurate and correct to the best of your knowledge. You understand and agree that this completed form constitutes the entire agreement between you and San Juan County 4-H. You intend to sign this agreement electronically, and your click serves as your legally binding electronic signature.Signed Veterinary Letter(Required) Drop files here or Select files Max. file size: 80 MB. To be considered for replacement, this form must be submitted to the Extension Office within 48 hours of the date of the veterinary exam. The date of the exam must be stated on the veterinary letter. You may mail, e-mail, Fax, or deliver this form and veterinary letter to the 4-H Project Coordinator. If you chose to mail this form and letter, the postmark must be within 48 hours of the examination date. Attention: Jennifer Krembs and Kandi Calendra 4-H Extension Office 221 Weber Way Suite LL Friday Harbor, WA 98250 Fax: 378-2187 Δ Link to Printable Form (PDF)