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Last:

NO REFUNDS AFTER June 1, 2011.

M/F

Last: XL

Phone

Roommate Choice (1 only – NO CHANGES)

Alternate Phone

Kayaking (swim test required) Learn techniques of paddling a one-man canoe Let’s Eat Prepare and enjoy fabulous foods Low Ropes Teaches team building and self-esteem Multimedia Learn to use digital and video cameras, design and create camp news segments and camp videos National Treasures Go on a scavenger hunt with GPS units to find hidden treasures and received unbelievable gifts Outdoor Adventure Hands on discovery, explore a nature trail, hike & camp Outdoor Sports Learn to play a variety of outdoor sports Performing Arts Create, write, produce & perform plays, skits, & commercials Photography Sharpens photography skills, take better pictures Riflery Shooting education and safety Robotics (2 period class) Utilizing LEGO Mindstorm Robotics sets, campers will learn to use this leading edge technology Scrap It Make lasting memories by scrapbooking Sewing Design and sew projects using college team fabric Small Animals Learn about and how to care for various domestic animals Swimming, Beginner Learn strokes & safety in Olympic-size pool Swimming, Advanced (swim test required) Advanced strokes, underwater swimming Wii Get Fit Use the Wii machine to get physically fit — Let’s workout!

Adult T-Shirt Size

L

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Archery Fundamental archery skills, safety, history Arts & Crafts Learn various craft techniques, and take projects home Basic Horse Learn to lead, mount, dismount, groom, stall care Bath and Body Make your own novelty and scented soap, bath salts and lotion. Boot Camp Drill formation, self-defense techniques, battlefield Canoeing (swim test required) Basic technique & safety for advanced swimmers CIT—Counselor in Training (must be 13 by 01/01/11) 4-H Training for Teen Leaders Cheerleading Create fun cheers for 4-H group names and competitions Climbing Learn techniques to use in outdoor rock climbing Computer Science Surf the internet, create newsletter, web page design CSI Crime Scene Investigator—Solving Crimes! WOW Dance Learn basic steps for jazz dance Environmental Science Exploring nature through hands on activities and water Fishing Bait and cast from shores of Smith Mountain Lake Garage Band A streamlined digital audio workstation (DAW) and music sequencer, which can record and play back multiple tracks of audio Golf Learn the techniques of teeing off and playing 18 holes Hemp Get ready for the beach! Custom made jewelry for boys and girls Hip Hop Dance fast paced/fast beat dance with a mixture of Zambia and other cultures Karate Learn basic stretches, blocks, kicks, and self-defense

Homeroom Teacher

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CLASS LIST (con’t)

School

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CLASS LIST

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Parent/Guardian (Please Print)

First:

Race

Black White Am. Indian Hispanic Asian Multi

Mailing Address

Gender

Date of Birth

_____/_____/_____

PARENTS email address (required)

4-H Junior Camp is for 4-H’ers who were 9-13 years of age by September 30, 2010, and are in the 4th grade or above. Campers are assigned to lodge rooms and groups prior to camp. 4-H’ers will attend 4 classes per day. On the registration form, you will choose, in order of preference, 8 classes. Classes will be assigned on a first come, first serve basis; therefore, campers may not get all choices. Rooms accommodate 4-6 campers. You are allowed to choose ONE friend to room with. NO changes will be made.

Middle

Spend a Fabulous…Fantastic…Fun-filled week at the beautiful W.E. Skelton 4-H Education Conference Center at Smith Mountain Lake nestled in the Blue Ridge Mountains. 4-H’ers will board buses at Liberty Fair Mall at 8:00 a.m. on July 11th and return to the same location on July 15th at 12:00 noon. The cost of camp is $215 which includes: Transportation, Lodging, Meals, Classes and Insurance.

Name of 4-H’er (please circle/ write name child is to be called by)

New Friends, Learn New Skills, Build Confidence and Create Memories

First:

4-H Junior Camp is the Place to: Make


Camp fees are due on registration day with a check or money order (cash will NOT be accepted) in the amount of $215 payable to: Henry Co.-Martinsville 4-H (a stamp will be available)

Once registration is received, 4-H’ers will receive information about camp including: • What to bring and what not to bring • Health History Form • Code of Conduct • Equine Release

For more information contact:

Brian L. Hairston, 4-H Agent bhairsto@vt.edu

Lisa R. Laliberty, 4-H FNP Asst. linelso1@vt.edu

Donna D. Draper, UAA ddraper@vt.edu

276-634-4650

These forms are due in the 4-H Office by: MAY 13

Or bring it to : Henry County Admin. Bldg. 3300 King’s Mtn. Rd. Room 102, NOTICE: Two weeks prior to camp, you will receive bus and lodging information and a medication report form. These will be sent to you via email rather than postal service. If you do not receive these forms by July 1, contact our office.

Preview Guide

4-H CAMP COLLAGE

DE AD LIN E

Mail forms to: Virginia Cooperative Extension Henry County-Martinsville P. O. Box 7 Collinsville, VA 24078

2011 Junior Camp

Capture your Child’s 4-H Camp Memories!

Preserve your child’s camp experience by purchasing a

Camp Week

16 X 20 photo collage for only $20.00. Your

July 11 thru July 15, 2011

collage will have a minimum of 5 photos specific to YOUR CHILD’S camp experience. Your collage will have a similar layout as the sample shown. It will have a 4-H Camp title and location. Your photo collage will be ready for pick up in the 4-H Office on August 22, 2011. Last date to order is June 24 and order must be paid in full when placed. Checks/Money orders should be made out to 4-H Adult Leaders.

If you are a person with a disability and desire any assistive devices, services or accommodations to participate in this activity, please contact the Henry County-Martinsville Office at 276-634-4650 during business hours to discuss accommodations two weeks prior to this event.

W. E. Skelton 4-H Educational Conference Center at Smith Mountain Lake

REGISTRATION April 30, 2011 8:00 A.M. Henry County Administration Building

Making the BEST

BETTER!


4-H Camp Brochure