Presenter or Room Host Registration Form

California North Central Section 4-H Presentation Day - UC Davis Campus • March 30, 2013

PLEASE PRINT CLEARLY!!

County: / Club
Name:
Street
City / Zip
Phone: (include area code) / Email:
 I am willing to be a ROOM HOST. Room Hosts need to be 11 years old or older and must have given at least one presentation at county level or have been a Room Host at a County Presentation Day. Room Hosts do not need to be presenters.
 I am willing to be a COURIER.Couriers need to be 9 years old or older. Couriers will run materials from rooms to the Tally Room. Couriers do not need to be presenters.

Presentation Information:

Must be the same entry and category as your 2013 COUNTY presentation

Name of Presentation:
Type: Demonstration Illustrated Talk Educational Display
 Scientific Demonstration Scientific Illustrated Talk Problem-Solving Presentation
 Prepared Speech  Impromptu Speech Interpretive Reading
 Share-the-Fun Cultural Arts Audio-Visual Presentation
Please see the State Presentation Web site for the State Guidelines, judging forms , and information concerning new and exciting things happening at State 4-H Field Day.
Grade Category: Primary  3rd and below (Not judged and will not go on to State)
Junior: 4th 5thIntermediate: 6th  7th 8th Senior: 9th and above

Teammates (team only. NO SUBSTITUTIONS ARE ALLOWED):(list Additional teammates for Share-the-Fun/Cultural Arts on Page 2)

Teammate #1: / Grade:
Teammate #2: / Grade:
I will also be entering a registration for Share the Fun or Cultural Arts as a 2nd entry Yes No (Circle)
I need to give my presentation outdoors (for live animals, etc.):YesNo (Circle)
 Please check here for special accommodations for your presentation and describe:

2013 Sectional Presentation Day Registration Form

Page 2

By signing this form, I state that the information on this form is correct to the best of my knowledge. Unsigned forms will not be accepted.

Signature of Participant(s): ______Date: ______

______

(If more than 2, please sign next to your name listed below)

County Presentation Day Coordinator: ______Date: ______

Please return your Registration form to your County Presentation Day Coordinator or County Presentation Day Coordinator as soon as possible.

______

SHARE THE FUN OR CULTURAL ARTS PARTICIPANTS

Adult Leader: ______

(NO SUBSTITUTIONS ARE ALLOWED)

Teammate #3:
Teammate #4:
Teammate #5:
Teammate #6:
Teammate #7:
Teammate #8:
Teammate #9:
Teammate #10:
Teammate #11:
Teammate #12:
Teammate #13:
Teammate #14:
Teammate #15:

If more space is needed attach additional sheets or use back of this if only one sided…