Entrepreneurship Conference

   Registration is limited to 35 participants for each session.  Registration, code of conduct, photo release, medical forms and money will be due by June 16, 2008 to the 4-H Office.The cost for each participant is $5.00.

Name :
Required for Civil Rights purposes.
Gender :
Required for Civil Rights purposes.
Ethnic Background :
Age Division :
Address :
City :
State :
Zip Code :
Name of Guardian :
Home Phone :
Cell Phone :
Email :
Please list any restrictions/allergies/special arrangements that you may have or need: :