Holiday Lake 4-H Educational Center

Full Name*

First Name Last Name

Name you wish to have one your name tag:*

Birth Date*

Month Day Year

Gender

Male Female

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

E-mail*

Phone Number*

- Area Code Phone Number

Class sizes are limited, first to register has first choice of classes, parents and youth must take the same classes. For each session pick your top three choices. Your alternate selections (choices 2 & 3) will be used if your first class choice is full. No class changes after arrival.

Saturday, September 29

Session 1- (8:00am-11:30am)
Session 2- (1:30-5:00pm)

Session 1 - First Choice*

Session 1 - Second Choice*

Session 1 - Third Choice*

Session 2 - First Choice*

Session 2 - Second Choice*

Session 2 - Third Choice*

Sunday, October 2 Session 3- (8:00am-11:30am)

Session 3 - First Choice*

Session 3 - Second Choice*

Session 3 - Third Choice*

T-shirt size (adult sizes only)*

Virginia Water Fowling Workshop Registration September 30-October 2, 2011

Virginia Water Fowling Workshop Registration
September 30-October 2, 2011