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, Code of Conduct, and Acknowledgement of Risk along with the New York State 4-H Permission Slip.

4-H Adult Forms

All adults participating in 4-H events or activities must complete an Acknowledgement of Risk for each event:

Acknowledgement of Risk - Adult

Leaders and volunteers must reenroll each year using the Volunteer Enrollment Forms. 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.

Submitting Forms

Digital Enrollment Forms

This year, we are able to collect the enrollment forms through Adobe Sign, allowing us to accept digital signatures. If you would like to enroll using the digital system, please contact Kristin Ruggiero at klf37@cornell.edu. She will email you the forms from the email 'echosign@echosign.com.' Please ensure that a parent/guardian digitally signs the documents.

Hard-Copy Enrollment Forms

If you prefer to enroll with physical signatures, please email Kristin at klf37@cornell.edu to receive the documents. You can print them 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

Last updated July 10, 2023