4-H Online Forms

Welcome to your source for all Jefferson County 4-H Forms!

Most of the forms below are fillable PDF’s so please complete them on your computer for accurate recording. Most of the forms require signatures. If you have the computer capability you may sign them electronically, or please print them in order to add a signature(s).

Forms should be emailed, faxed, or mailed to:

Amy Zukas
Cornell Cooperative Extension of Jefferson County
203 North Hamilton Street
Watertown, NY 13601
Fax: 315-788-8461
Email: asw247@cornell.edu

Basic 4-H Forms:

4-H Enrollment/Re-enrollment Packet (Non-Horse): A 4-H Enrollment Packet needs to be completed when youth wish to join 4-H as well as each year they would like to re-enroll in 4-H. It is also used to change their contact information when necessary. This form must be signed by both the 4-H member and their parent or guardian. Please be sure to complete the entire form.
4-H Enrollement/Re-enrollment Packet (Horse): This is a specific enrollment packet meant for 4-H youth involved in equine activities. If you are in a 4-H horse club or participate in 4-H horse activities, please fill this version out instead of the one linked above.
NYS 4-H Code of Conduct: All 4-H Participants—youth, families, volunteers, and Extension staff—in or attending any activity or event sponsored by Cornell University’s Cornell Cooperative Extension (CCE) 4-H Youth Development Program are required to uphold the values of the NYS 4-H program and conduct themselves according to these standards. The standards also apply to online activity, including social media internet presence. (This form is included in the 4-H Enrollment/Re-enrollment Packet.)
4-H Project/Activity Record Book: This book is completed at the end of the 4-H year (October 1) or prior to the Jefferson County 4-H Youth Fair. This Project/Activity Record is used as a tool to complete a project for the County Fair or to turn into the 4-H office so that the youth can be acknowledged during the recognition event in November.
4-H Cloverbud Project/Activity Record: This Project/Activity Record is used as a tool to complete a project for the County Fair or to turn into the 4-H office so that the youth can be acknowledged during the recognition event in November.
New York State 4-H Portfolio - Annual Summary: The 4-H Portfolio documents a young person’s participation in 4-H projects and activities throughout his/her membership years. Each year an annual summary of all 4-H participation and individual project records are added to the portfolio. It is recommended that these materials be kept in a 3-ring binder with the most recent year in the front of the book. While 4-H members officially start their portfolios when they enter grade 3, Cloverbud records may be kept in the back of the book.

Acknowledgment of Risk Forms

There are different 4-H Acknowledgment of Risk Forms depending on the 4-H member’s age, what type of club they belong to, what type of activity they may be engaging in, and more. In some cases, more than one Acknowledgement of Risk form may be required.

4-H Member Acknowledgment of Risk Form – Required for all 4-H members. This is included in the 4-H Enrollment/Re-enrollment packet.

4-H Equine Acknowledgment of Risk Form – Required for all 4-H members age 8 or older as of January 1st of the current 4-H year that participate in Equine Clubs or Equine programming.