Polk County Youth Fair Entry Form

Deadline May 30, 2023

Pre-registration guarantees participant a t-shirt

Youth and Adult Sizes: Small, Medium, Large, XL

Name t-shirt size

Complete Address

Phone Name of FFA Chapter, 4-H Club

Email address Date of Birth

4 & 5 years olds must be entered in the Pee Wee Class only

Class Number & Class Name as listed in the book Birth Date of Livestock* Breed*

Division (Use separate form for each division)

The animal(s) listed above is owned and/or cared for by the exhibitor and is approved to show. The above listed farm mechanics item(s) or field crops exhibit(s) were made or grown by exhibitor.

Signed Leader, Vo-Ag Instructor, 4-H Specialist of (if not a member of club, Parent)

Submit completed entry form to Polk County Extension, 110 E Jefferson Bolivar, MO 65613 (326-4916); email: drakek@missouri.edu oPlease check if you plan to participate in the Premium Sale