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4-H Member name printed Club Name
4-H Member signature Date
Parent or guardian signature Date
4-H Leader signature Date
Return top copy to the University of Nevada, Reno Extension Washoe County Office, 4955 Energy Way, Reno, NV 89502 by November 15 of the current year or at the time of enrollment
Published by: S. Chvilicek, C. Stark, Horse Leaders' Council, 2022, Washoe County 4-H Horse Program Commitment to Excellence, University of Nevada, Reno Extension, 4-H Forms
An EEO/AA Institution. Copyright © 2026, University of Nevada Cooperative Extension. A partnership of Nevada counties; University of Nevada, Reno; and the U.S. Department of Agriculture