May 17, 2017 UNR Equestrian Center Reno, NV

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1 May 17, 2017 UNR Equestrian Center Reno, NV The due date for complete applications to be received by the State 4-H Office in Reno is May 5, Please note that your application requires the signature of a UNCE 4-H Representative; therefore, each County 4-H Program/Office may have an earlier due date than the State 4-H Office. County Due Date: The primary goal of the State 4-H Livestock Judging, Skill-A-Thon, & Quiz Bowl Contests are to recognize and interpret visual differences between livestock animals and to understand livestock production and management practices. These are valuable skills for 4-H Club Members to learn, comprehend, and utilize. The State 4-H Livestock Judging, Skill-A-Thon, & Quiz Bowl Contests are open to all County 4-H Programs throughout Nevada. All 4-H Club Members are eligible, except for the following situations: No 4-H member who has taken post-high school Animal Science, Livestock Judging or related subject courses may enter. Any member who has competed in a National Level 4-H Livestock Judging Contest, 4-H Skill-A-Thon Contest, or 4-H Quiz Bowl Contest will be ineligible to compete in the same contest at the State Level. However, the member is encouraged to become a junior coach for the county clubs and become involved in other aspects of the program. *Addendum: Youth who have competed in a National 4-H Contest may be a practice participant in the same contest at the State 4-H event. A practice participant s scores will not be considered for the State 4-H Contest awards and placings. The selection of eligible individuals and teams is the responsibility of County 4-H/Extension Staff. State 4-H Livestock Judging and Skill-A-Thon Contests As many eligible contestants in each age category Counties allowed to partner with other counties to create a full team. Age category classifications are as follows: State 4-H Livestock Quiz Bowl Contest Junior Age Requirements: 9 & 10 years of age on January 1, 2017 Intermediate Age Requirements: years of age on January 1, 2017 Senior Age Requirements: years of age on January 1, 2017 ONE team of four (4) or five (5) eligible contestants per age category Counties allowed to partner with other counties to create a full team Each county entering any of these contests must provide at least two individuals and two back-up individuals to assist with the operation of the contests. Delegations from each county will be responsible for chaperones for their county along with room and travel arrangements. At least one chaperone per ten (10) youth is required and they must be certified 4-H Volunteers. Counties and areas are encouraged to work cooperatively. A schedule of events is provided for check-in times of each contest. A map of the location of the event is also provided. The University of Nevada, Reno is an Equal Opportunity/Affirmative Action employer and does not discriminate on the basis of race, color, religion, sex, age, creed, national origin, veteran status, physical or mental disability, and in accordance with University policy, sexual orientation, in any program or activity it operates. The University of Nevada employs only United States and aliens lawfully authorized to work in the United States.

2 2017 State 4-H Livestock Contests Entry Form Livestock Judging, Livestock Skill-A-Thon, & Livestock Quiz Bowl May 17, 2017 Please PRINT legibly. Submit complete forms to the State 4-H Office in Reno with registration fee no later than May 5, Please make payment to Board of Regents Send forms to: Frances Brown University of Nevada Cooperative Extension Attn: 4-H Livestock Contest MS0404 Reno, NV Registration fee is non-refundable after May 9, 2017 Judging/Skill-A-Thon Registration Fee: $15 per Contestant Quiz Bowl Registration Fee: $25 per Team Registration includes: Saturday lunch Officials (Judging) Animals T-shirt Contest materials. Name: Date of Birth: County: Address: (Street) (City) (State) (Zip) Phone: Needs Special Accommodations (please attach a detailed note) Gender: (check) Special Dietary Requirements: (female) (male) Check Contests Entering Age Division? Jr/Int/Sr Type of Participant?* PP or Part. T-Shirt Size (Adult Sizes) Contests Entry Fee Livestock Judging $15 Livestock Skill-A-Thon $15 Livestock Quiz Bowl: $25 List Team Members (include yourself) *See 1 st Page for More Info on Participant Type* TOTAL $ Parent/Guardian Name: Parent/Guardian Phone: Parent/Guardian Signature: Date: County 4-H Staff Signature: Date: Persons with disabilities who require alternative means of communication for program information or reasonable accommodation need to contact Frances Brown by May 9, 2017 at the State 4-H Office, This Entry Form, Entry Fees, Assumption of Risk, and Photo Release Forms are due to the State 4-H Office by Friday, May 5, 2017.

3 2017 State 4-H Livestock Contests Schedule of Events* Wed: May 17, 2017 UNR Equestrian Center 8:00 am-8:30 am Check-In for Livestock Skill-A-Thon Contest 9:00 am-12:00 pm Livestock Skill-A-Thon Contest 12:00 pm-12:30 pm Lunch and Check-In for Livestock Judging 1:00 pm Start Livestock Judging Following Livestock Judging there will be a 30 minute break. After this short-break Check-In for the Quiz Bowl Contest 30 Minutes later Start Quiz Bowl Contest Awards for all 30 minutes following the Quiz Bowl Contest *Schedule may change. ** If coaches wish to provide a snack or drink to their contestants between judging and reasons, that is acceptable and permissible.

4 University of Nevada Cooperative Extension Participation Form Parent/Guardian s Assumption of Risk on behalf of Minor (less than 18 years of age) Parent/Guardian Name: Minor s Name: In consideration of the acceptance of my application for participation in and specifically, I hereby freely agree to and make the following contractual representations and agreements on my behalf and on behalf of my Minor (hereafter referred to as Minor ). I fully realize the dangers of participating in said event and I voluntarily assume all risks associated with such participation on my behalf and on behalf of my Minor. I understand these risks include, by way of example and not limitation the following: ( Initial ) I understand that participation in is an inherently dangerous activity, and that no one can guarantee my Minor s safety while participating in or observing this activity. I understand all of the risks and dangers which arise from this activity and knowing those risks and dangers, it is my wish to allow my Minor to participate in and/or to observe this activity. (Initial) For myself, my Minor, and our heirs, executors, administrators, legal representatives, assignees and successor in interest (collectively referred to as "successors"), I release, forever discharge and agree not to sue the Nevada System of Higher Education (hereafter referred to as NSHE ), its employees, agents, members, sponsors, volunteers, officials, spectators, or owners of property on which this activity may be conducted from any and all liability, claims, loss, cost or expense, including, but not limited to, those arising from property damage or loss, injury to my Minor s body, mental trauma, or death, and waive on behalf of myself and my Minor any such claims against any such persons or organizations, arising directly or indirectly from, or attributable in any legal way to, any negligence or other action or omission to act of any such persons or organizations in connection with the sponsorship, or organization or conduct of the above event/activity including travel to and from such event or activity in which my Minor may participate as a participant, spectator or volunteer. I hereby waive for myself and on behalf of my Minor all such claims which I have or my Minor has now, or may hereafter have against the above organizations or persons, however caused. (Initial) I agree on my behalf and on behalf of my Minor that it is my Minor s sole responsibility to be familiar with the grounds, buildings, and other facilities, rules, other applicable rules or special regulations for the above event. I understand and agree that situations and conditions may arise prior to, during, or following the event which may be beyond the control of NSHE, its employees, agents, members, sponsors, volunteers, and officials, and I must participate so as to neither endanger my Minor or others. (Initial) I agree for myself, my Minor, and our successors that the above representations and agreements are contractually binding and shall bind me, my Minor, and our successors for the above event. I agree that if I, my Minor, or our successors assert any claim or bring any suit in violation of this agreement, I, my Minor, or any of our successors shall be liable for the expenses (including legal fees) incurred by the other party or parties in defending against such claim or suit. (Initial) I have carefully read this participation form and fully understand its contents. I am aware this is a release of liability, a waiver of claims, and agreement not to sue, and a contract between myself on my behalf and on behalf of my Minor and NSHE. Signature of Participant: Name: Date: Minor's Parent or Guardian Consent: We undersigned parent or guardian of a minor do hereby consent to any x-ray, examination, anesthetic, medical or surgical diagnosis or treatment and hospital service that may be rendered to said minor under the general or specific instructions of any physician or hospital. It is understood that this consent is given in advance of any specific diagnosis or treatment which may be required, but is given to encourage university employees, event staff, hospital staff, and such physician to exercise their best judgment as to the requirements of such diagnosis or treatment. The undersigned shall pay all fees for doctors, hospitals and other medical charges reasonable and necessarily incurred. Signature of Parent or Guardian: Person to contact in emergency: Parent/Guardian: Phone Number: Physician: Phone Number: Signature of Cooperative Extension staff: An EEO/AA institution October 2010

5 NEVADA 4-H 4-H Photo/Audio/Video/Quote/Name/Town Release (Approved/Revised; August 2010) I give permission, without restriction, to the University of Nevada Cooperative Extension/Nevada 4-H to: photograph me video record me audio record me quote me state/use my name please circle..yes..no state/use my hometown I grant the right to use the materials/information listed above for educational and promotional use, as directed by the university, without payment or remuneration for any appearances, use or displays. I acknowledge the university s right to crop or treat the display of my photograph at its discretion. I understand that the university may use these materials in printed and Internet publications and presentations that they produce, and that they may also give the material/information to media and other organizations for educational or promotional use. I also understand that the use of this material/information is done without remuneration/payment to me. I agree to the above conditions: Name of Participant (Print) Signature of Participant I agree to the above conditions: If participant is under 18 years old, name of Parent or Guardian (Print) If participant is under 18 years old, signature of Parent/Guardian Date of Completing Form The University of Nevada, Reno is an Equal Opportunity/Affirmative Action employer and does not discriminate on the basis of race, color, religion, sex, age, creed, national origin, veteran status, physical or mental disability, and in accordance with University policy, sexual orientation, in any program or activity it operates. The University of Nevada employs only United States and aliens lawfully authorized to work in the United States. Women and under-represented groups are encouraged to apply.

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