2019 State 4-H Congress Registration
Registration is due by June 24th.  But I would like you to register ASAP so I know how many rooms to request for everyone.  Payment or arrangements for payment is due by June 27th.  More specific information will be sent after registration is received and a little closer to time.

You will need to pay for 4 or 5 meals on our own depending on the option you choose for Saturday.   We are staying in Holiday Inn Express on Gorman Street near NCSU with 3 people/room.  Breakfast will be at the Hotel and you don't have to bring towels or bed linens.

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Email *
First Name *
Last Name *
Emergency Contact Phone Number *
Delegate E-Mail *
4-H Age *
As of January 1, 2019
Birthdate *
MM
/
DD
/
YYYY
Gender *
Years in 4-H *
Registration Options *
Payment Methods *
Please make sure to check your clover cash listing here.  go.ncsu.edu/clovercashbalance
Required
Please Choose Meal Type *
Dietary Restrictions/Allergies *
Please list any special needs or accommodations that may be required to enable you to participate in this program *
Please check T-Shirt Size
These are adult sizes.
I give permission for NCSU to take photographs and/or record video and/or audio and likenesses of me. *
Required
I hereby understand that North Carolina 4-H Youth Development does not accept any responsibility, custody, or liability for any of my personal property that I may bring to this event.  It is understood that it is my personal responsibility to safeguard such personal property of mine. *
Required
I hereby understand that North Carolina 4-H Youth Development operates under a code of conduct and have read, understand and agree to the terms described therein. *
Required
Activity Winners *
This year at 4-H congress we will be recognizing all of our State level activity and award winners from across the state since last year's 4-H Congress.  They will be recognized as a group during Sunday afternoon's assembly.  Please select the appropriate boxes below so we can properly record this information when we register you for State Congress.  Some of these you will not know yet.
Required
If you are a Senior graduating in 2019.....
Please list the name of the College you are Attending in the Fall and your Major
Do you want to be considered for the 4-H Congress Media Team? *
Please list the name of the College you are Attending in the Fall and your Major
If yes, in 50 words or less describe your experience with taking photos/videos and using social media to promote 4-H. *
Please list the name of the College you are Attending in the Fall and your Major
Please indicate a 1st, 2nd and 3rd Roommate Preference *
I reserve the right to room 4-H'ers together as needed, but will keep your choices in mind.  Your roommate choice must be within 3 years of your age.  Ex.  a 13 year cannot be roomed with someone over 16.  If you don't have a preference, please put, no preference.
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