PLEASE NOTE: New this year—If you turn everything in with your application by May 20, 2016 you will receive a ticket. One ticket will be drawn on May 21st.

Winner will receive $25.00 off their camp fee.

Also, remember your spot will not be guaranteed until all parts of the application are turned in.

Camp Form Checklist—You must have everything before your space will be reserved.

_____Fill out en re Registra on/Health Form 3 pages – be sure parent signature is on page 1

_____Include Health Exam and immuniza on record (dated in the last 24 months)

_____Include copy of both sides of Insurance Card

_____Fill Out & Sign Pick‐Up Release form

_____Fill out A Few More Things Page (Roommate, Shirt Size, Etc.)

_____Money. Have to have CHECK for at least $25. Payable to: Kenton County 4‐H Council; $190 by May 20; A er May 20 it is $210. NO CASH ACCEPTED THIS YEAR!

Please Note:

New This Year

Dear Parent/Guardian and Camper, You are invited to join the fun with Kenton County at Summer 4‐H Camp! This is the applica on packet for 2016. Please read all informa on carefully; we have made a few changes from last year. Registra on deadline is June 10, 2016 and you must have a complete applica on in order to guarantee your spot. NEW THIS YEAR: If you turn in all parts of your applica on before May 20, you will receive a cket. We will pull a winning cket on May 21. That camper will receive $25.00 off their camp fee. Camp is filled on a first come‐first serve basis so don’t delay. If you have any ques ons, call the Kenton County Extension Office at 356‐3155.

Sincerely,

Denise Donahue Kenton County Extension Agent 4‐H Youth Development

Dates: 4‐H Camp Monday, July 4 through Friday, July 8. We will meet Monday a ernoon, July 4, at the DURR ANNEX on Dixie Highway in Edgewood (K‐Mart Plaza) at 1:00 p.m.

Ages: 9‐14 (must be 9 before the first day of camp) Cost: $210.00 ‐20.00 (Save $15 if fee is paid by May 20—early bird deadline) $190.00 Your Cost (if paid by May 20) This cost includes transporta on, lodging, meals,

snacks, class fees, and tee shirts. Three‐month payment plans are available. They will be set up on an individual basis.

How to Register: Complete the applica on packet and return to: Kenton County 4‐H Camp; Kenton County Extension 10990 Marshall Rd., Covington, KY 41015.

Please be sure to include EVERYTHING on the Checklist. Camp Orienta on This is Mandatory! You must a end one orienta on from the following two

dates: Monday, May 23, 6:30 p.m., at the Durr Center, corner of Marshall and Taylor Mill Rd. and Monday, June 20, 2016, 6:30 p.m. at the Durr Annex, Dixie Highway.

LaRosa’s Fund Raising: If you are interested in fund-raising please call the office and talk to Mary Cannon or Denise Donahue at, (859) 356-3155. You must make a $25 non‐refundable deposit with your applica on.

July 8th

Kenton

A Few More Things… All of the information is important, but what’s more fun than picking out your roommate and camp classes!

Camper Name: ___________________________________________________________

Age: ______________ Gender: ____ Female ____ Male Grade Entering: _______

School A ending Currently:

________________________________________________________________________

Current Homeroom Teacher:

________________________________________________________________________

Preferred Cabin Mate (List only 1):

________________________________________________________________________

T‐Shirt Size:

____Youth Small ____Youth Medium _____Youth Large _____Other, please list

____Adult Small ____Adult Medium _____Adult Large _____Adult X Large

During 4‐H Camp, each camper will have the opportunity to par cipate in four classes.

These classes are filled on a first come, first serve basis.

We will start signing up for classes at the first orientation on May 23, 2016, at the Kenton County Extension Office.

First come first served.

Please return this form with the completed application!

4-H Camp Scholarship Application

Camper Name: __________________________________________________

Why do you want to attend 4-H Summer Camp? ________________________ ______________________________________________________________________________________________________________________________

What other 4-H clubs or activities have you participated in during 2015-16?

______________________________________________________________________________________________________________________________

Do you receive free or reduced lunch at school? ________________________

Signature and Title: ______________________________________________

Relation to Child: _______________________ Phone Number_____________ Other than family, could be teacher, Guidance Counselor, FRC director, 4-H Agent, or person from Church or community organization.

Why do you feel this child should receive a 4-H Camp Scholarship? __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Scholarships are limited and will be awarded on need basis. If you wish to apply for a camp scholarship, this application must be completed and

submitted with your camp application. Also, a $25 deposit must accompany your completed scholarship form and camp application. The application will not be considered without a $25 deposit. If we are unable to extend a scholarship and you are unable to attend, the deposit will be

returned. The amount of the scholarship is up to the discretion of the agents. First time applicants will take precedence over others. Children

receiving scholarships must adhere to all deadlines and requirements regarding pre-camp orientation and completion of paper work.

Deadline to apply for scholarships is May 20.

Ask a Teacher, Guidance counselor, Family Resource Center Director, 4-H Agent, or person from your church or community organization to complete the following: