King County 4-H

Enrollments for 2018/2019

DUE TO THE 4-H OFFICE BY DECEMBER 15, 2018

CLUB NAME_____________________________________________________

Members (must be between the ages

of 5 and 18 as of October 1, 2018	NO.

Returning and new members paying by check	X $30.00	=

(Submit one club check or money order made out to King County 4-H Association

List members for whom the enclosed fees are being paid. Enrollment is not complete until fees received.

List youth requesting a waiver. (If partial waiver, how much is included in the submitted payment)

Name amount of waiver request	balance if partial waiver

Overall total $__________

Submit to King County 4-H Association 1000 Oakesdale SW Suite 140 Renton, WA 98057

List youth who are enrolling in King County 4-H and payment is made online via credit card

New enrollments throughout the remainder of the 4-H year should be turned into the 4-H office within two weeks of the new member joining your club