4-H Enrollment Forms

4-H Youth Enrollment

The 4-H year begins on October 1 and ends on September 30. To enroll in 4-H for the 2021-2022 year, complete the 4-H Member Enrollment Form, Code of Conduct, and Acknowledgement of Risk (all included in the 'Combined' Forms), along with the New York State 4-H Permission Slip. If you plan to work with horses (i.e. with a horse club or with 4-H Veterinary Science), please complete the 'Combined Files Horse.'

Rockland 4-H 2021-2022 Enrollment Combined Files Non-Horse

Rockland 4-H 2021-2022 Enrollment Combined Files Horse

New York State 4-H 2021-2022 Permission Slip

4-H Adult Forms

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

Acknowledgement of Risk - Adult

The following Leader/Volunteer Enrollment Forms are for existing leaders and volunteers. 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.

Rockland 4-H Volunteer/Leader Enrollment Form

NYS 4-H Permission Slip

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 ensure that all enrollment forms are completed and signed, then 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 September 9, 2021