2013 STATE 4-H ROUNDUP YOUTH REGISTRATION FORM DUE TO ARRIVE BY 5:00 P.M. JUNE 21, 2013

Return ONE form per youth and ONE check per county, TO: Ag Conference Services, 430 Student Union, Stillwater, OK 74078.

Completed forms will be worked in order they are received.

PRINT or TYPE

Name Gender

Home Address

City Zip Phone

Email Address

Emergency Contact Name and Phone #:

Grade County District T-Shirt Size (for County Use Only)

Are you a First Timer? YES or NO Are you a Final Timer? YES or NO

PRE-REGISTRATION IS REQUIRED FOR ALL WORKSHOPS AND COMPETITIVE EVENTS

Optional Information: This information will be used for reporting Civil Rights and Affirmative Action compliance.

With which group(s) do you identify? _____ African American _____ Asian/Pacific Islander _____ Caucasian _____ Latino _____ Native American _____ Of Hispanic Origin Do you have affiliation with any Native American tribes? (Please circle one) YES NO If yes, please indicate:

For individuals with disabilities who require auxiliary aids or services for program participation, please identify the accommodation/service needed when submitting this form. Advance notice is necessary for effective service provision; it may not be possible to provide some aids and services with late notice. Reasonable effort will be made to accommodate individuals who request auxiliary aids or services.

Oklahoma state university, in compliance with title vi and vii of the civil rights act of 1964, executive order 11246 as amended, title ix of the education amendments of 1972, Americans with disabilities act of 1990, and other federal laws and regulations, does not discriminate on the basis of race, color, national origin, sex, age, religion, disability, or status as a veteran in any of its policies, practices or procedures. This includes but is not limited to admissions, employment, financial aid, and educational service Name County: WEDNESDAY COMPETITVE EVENTS – SEE GUIDELINES ON WEBSITE Only one competitive event from this section may be entered. NOTE: Speech, Illustrated Pres. or PowerPoint presentation should have been previously presented at a county or district contest or for a local organization to enter public speaking at Roundup

Put an X in front of the event and list the two digit category number (Note: These codes were revised in 2013). ______IL. Illustrated Presentation Category #_____(1-5) If team, list partner______SP. Speech Category # ______(06-10) (Individuals Only) ______PP. PowerPoint Category #______(11-15) (Individuals Only) ______Vocal Contest (Additional form required. See requirements) ______FCS Skill-A-Thon Workshop/Contest (Check eligibility requirements on Roundup page. Individuals and county teams of 3-4 members who have competed in/or qualified for National Contest are not eligible to participate.)

AFTERNOON WORKSHOPS If you do not choose a competitive event above, you will attend one large group session based on your age and then one small group session (W)

3:15 – 4:15 p.m. Large Group –Wellness/Fitness Workshops CIRCLE your Age as of Jan. 1, 2013

13 14 15 16 17 18 19

4:30 – 5:30 p.m. Small Group – Wellness Workshops Rank your workshop choices (1-10)

_____W01: A Pocketful of Regrets! _____W16: Map Your Food! _____W02: Tomatoes Are Red, Berries Are Blue, Pineapples _____W17: Walk Your Way to Fitness Are Sweet And They All Look Good On You! _____W03: Health Rocks _____W18: I Spy! _____W04: Movin’ and Grovin’ with Oklahoma Agrability _____W19: Action Agriculture _____W05: Basic Nutrition with the OSU Wellness Staff _____W20: Social Health: Relationship and Dating Etiquette _____W06: Basic Fitness with the OSU Wellness Staff _____W21: Sports Nutrition for Teen Athletes _____W07: Active Teambuilding Initiatives _____W22: How to Get S’more Out of Life! _____W08: Zumba _____W23: Dance to Your Health! _____W09: Yoga _____W24: How Sweet it Is! _____W10: Healthy Stack of Yummy Snacks _____W25: How Much is Too Much? _____W11: Handling Stress _____W26: This Trails the Best Way _____W12: Wake Up to a Warm Up! _____W27: High Adventure _____W13: Healthy Choices While Eating Out _____W28: What Shoe Are You? _____W14: Get Moving with the Chickasaw Nation _____W29: Vegging Out _____W15: Healthy App-ortunities Name County: THURSDAY COMPETITIVE EVENTS – SEE GUIDELINES ON WEBSITE Only one competitive event from this section may be entered. Delegates not entering a competitive event will participate in the workshop sessions listed below. 1:30 p.m. – 4:00 p.m. _____ D01: Tractor Operator Contest (limit 3 intermediates and 3 seniors per county in this event - CERTIFICATION FORM REQUIRED) _____ D02: Land Judging Workshop and Computer Contest (NO TEAM REQUIRED) _____ D03: Clover Quiz Bowl (TEAM REQUIRED) _____ D04: Livestock Quiz Bowl (TEAM REQUIRED) _____ D05: Fashion Revue Contest (Requires Garment –See Contest Guidelines). Additional form required _____ D06: Job Readiness Contest– Intermediate ONLY (limit 3 per county in this event). Additional form required _____ D07: Job Readiness Contest – Advanced ONLY (limit 2 per county in this event). Additional form required _____ D08: Food Showdown – Participants must be District winners. If your district has NOT had its qualifying event, do NOT sign up for this event. You will be added by your District Coordinator later.

AFTERNOON WORKSHOPS If you do not choose a competitive event, you will attend two one-hour workshops (A & B) OR one two-hour workshop (C) Rank your choices (1-10) within this entire section

ONE HOUR WORKSHOPS _____A25: Themed Container Gardens _____A01/B01: Communication, Communication _____A26: Violence in Dating Relationships: When Love Hurts _____A02/B02: ....Yet! _____A27: Teambuilding with Technology _____A03/B03: Teamwork Trebuchet _____B28: Tree Identification _____A04/B04: Travelling Seas – OKC Zoo _____ B29: College Credit Now, Degree Tomorrow _____A05/B05: OKC Disc Dogs _____B30: Building a Toolkit to be a Success! _____A06/B06: Don’t Text and Drive _____B31: You Can Be a Tide-Turner! _____A07/B07: ATV Safety: Are You Ready to Ride? _____B32: Leading with the 4-H Fun Pack _____A08/B08: Tour the OSU Athletic Center _____B33: Who, What Where and Why NRCS _____A09/B09: Trash to Treasure for Teens _____B34: WaterWorks 4-U _____A10 /B10: Deer Hunting and Deer Management in OK _____B35: Drive Thru Nutrition – Order this, Not That! _____A11/B11: Make a Rain Gauge _____B36: Do You Know the Horse World? _____A12/B12: Color Crazy _____ B37: 4-H + OMK = Great Communities! _____A13/B13: Tie Dye with a Twist _____B38: Upcycled Crafts _____ A14: District and State Leadership Council _____B39: Entomology in Action Candidate Workshop _____A15: A Horse ...Of Course! _____B40: Hall of Fame Blue Award Group, National Congress Delegates and Record Book Scholarship Project Finalists – report to Gallagher for honor night assembly practice at 3:50 p.m. _____A16: It’s Cool to Be ME! TWO HOUR WORKSHOPS _____A17: Getting Your Goat...... Jerky _____C01: 4-H Leatherwork _____A18: Living in a Multicultural World _____C02: What’s in my water? _____A19: 4-H Food Showdown Workshop Fun _____C03: Where is “Thrown Away”? _____A20: Tour of the Boren Vet Med Teaching Hospital _____C04: The Science Behind Wind and Solar Power _____A21: Health, Hydration and Electrolytes _____C05: Are You an Entrepreneur? _____A22: Geology: Layers of the Earth _____C06: My Horse! Finished or Not Finished? _____A23: Making a Difference _____C07: This Into That! Eco-Friendly Clothing Redesign _____A24: Swine Center Tour _____C08: 4-H Has Talent Rehearsal (Pre-Selected)