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
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 firstname.lastname@example.org if you are interested in becoming a leader or volunteer.
Rockland 4-H Volunteer/Leader Enrollment Form
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 email@example.com. She will email you the forms from the email 'firstname.lastname@example.org.' Please ensure that a parent/guardian digitally signs the documents.
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:
Scan (or photograph) your documents and email them to Kristin Ruggiero, email@example.com.
Mail documents to:
Cornell Cooperative Extension of Rockland County
Attn: Kristin Ruggiero
10 Patriot Hills Drive
Stony Point, NY 10980
4-H Resource Educator
(845) 429-7085 x 103
Last updated September 9, 2021