4-H Enrollment Forms

4-H Youth Enrollment

The 4-H year begins on October 1 and ends on September 30. To enroll a child in 4-H, parents/guardians must complete the 4-H Member Enrollment Form, Medical Release, Acknowledgement of Risk, and the Code of Conduct.

This year, we will be collecting enrollment forms via Adobe E-Sign, allowing us to accept digital signatures.

Important Notes About the Forms:

1. Please use a computer or tablet: When completing the forms through Adobe ESign, we recommend using a computer or tablet rather than a phone. The mobile version can sometimes skip important fields.
2. Photo Release & Evaluation Consent: Please initial each section to confirm that you have read and understand it. You may opt out of photos or evaluations by leaving the applicable box unchecked. The photo release applies to candid and group photos taken during the program. If you opt out of photos, we will make every effort to ensure your child is not photographed. If they are unintentionally included in a photo, we will crop them out or blur their face before the photo is shared or used.
3. Code of Conduct: Both the youth and parent/guardian must sign. Please review the document together with your child and have them type their name in the youth signature field.

Digital Forms

2026 - 2027 4-H Enrollment Forms - Equine Member (for any youth who will interact with horses during a 4-H program)

2026-2027 4-H Enrollment Forms (for those not interacting with horses)

PDF Forms

2026 - 2027 4-H Enrollment Forms - Equine Member

2026 - 2027 4-H Enrollment Forms

If you prefer to enroll with physical signatures, please print the PDF forms at home and submit them through email or mail:

Email
Scan (or photograph) your documents and email them to Kristin Ruggiero, klf37@cornell.edu.

Mail
Mail documents to:
Cornell Cooperative Extension of Rockland County
Attn: Kristin Ruggiero
10 Patriot Hills Drive
Stony Point, NY 10980

4-H Adult Forms

Leaders and volunteers must re-enroll each year using the Volunteer Enrollment Forms. 

2026-2027 4-H Volunteer Enrollment Forms (Digital Form)

2026-2027 4-H Volunteer Enrollment Forms (PDF)

To become a 4-H leader/volunteer, adults must complete the Cornell Cooperative Extension Volunteer Application, which includes a Criminal and DMV History Check. Please contact Kristin Ruggiero at klf37@cornell.edu if you are interested in becoming a leader or volunteer.

Last updated September 14, 2026