2025 4-H Summer Camp in Felton, Youth Camper and Youth Staff Registration

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2025 4-H Summer Camp Santa Clara County

Campers will stay in cabins; restrooms and showers are provided;

meals, snacks, activities, and t-shirts are all provided.

Registration Deadline is May 22, 2025

Camp registrations received after camp is full (110 youth)

will be notified and added to the waitlist.

Unpaid registrations are considered to be incomplete.

Be sure to register & submit your payment early.

The SCC 4-H Financial Aid application is available in registration.

Members of other counties may inquire at their 4-H office about scholarships & financial aid.

To be considered complete, a camper's 4-H enrollment

MUST be "Active" in the ZSuite enrollment system

and payment made for camp registration.

Incomplete enrollment status registrations will be returned

to you by email as "incomplete."

If you need help in completing 4-H enrollment, please contact your club's Volunteer Enrollment Coordinator

or visit the "How to Join" page on your county's 4-H website.

4-H Camp is held in Felton, CA

Campers will arrive on Sunday, June 22 @ 3 pm

Pick up will be Thursday, June 26 from 3 pm - 4 pm

*Camp Staff will be on-site June 22 (9 am) - June 27 (11 am pick up)

Youth Camp Directors for 2025 are:

Rina O'Keefe, Victor Calderon, Elena McPherson, and Jackson La

✻ = Required

Camper's Last Name: ✻

Camper's First Name: ✻

Best email address for all notices: ✻

What County 4-H Program is the camper enrolled in? ✻

What 4-H Club is the camper involved in: ✻

Shirt Size: (One T-shirt is included with camp registration)

Shirts are not guaranteed for waitlist registrations received after May 22.

A = Adult Size

Y = Youth Size ✻

YL YXL AS AM AL AXL A2XL A3XL

Cabin and sleeping areas are assigned according to gender.

Please indicate the gender of the camper in the list below. ✻

Male Female Nonbinary Gender not listed Prefer not to state

FOR COMPLETION BY PARENT or GUARDIAN:

SHOOTING SPORTS PERMISSION -- I do hereby give permission to the Santa Clara County 4-H Youth Development Program, and to all officers, instructors, and assistants participating in the air gun safety and marksmanship activity at the Santa Clara County 4-H camp, to furnish an air gun, pellets, targets, instructional literature, instruction in air gun safety and marksmanship, and other equipment and materials pertinent to the instruction in air gun safety and marksmanship, with the understanding that:

(a) The above named minor will receive attentive supervision by a qualified person or persons during the course of the Air Gun Safety & Marksmanship activity;

(b) The above named minor will be instructed to wear eye protection at all times while shooting air guns, or when in the presence of anyone shooting air guns; and that such eye protection shall be furnished to the above named minor by the Santa Clara County 4-H Youth Development Program if the above named minor does not have such eye protection;

(d) All Air Gun Safety & Marksmanship Activity shooting shall be conducted on an air shooting range which is suitable for the safe conduct of air shooting. ✻

Yes No

ARCHERY SPORTS PERMISSION -- I do hereby give permission to the Santa Clara County 4-H Youth Development Program, and to all officers, instructors, and assistants participating in the archery activity at the Santa Clara County 4-H camp, to furnish a bow, arrow, targets, instructional literature, instruction in archery safety and marksmanship, and other equipment and materials pertinent to the instruction in archery safety and marksmanship, with the understanding that:

(a) The above named minor will receive attentive instruction and supervision by a qualified person or persons during the course of the Archery activity;

(d) All archery Activities shall be conducted on an archery range that is suitable for the safe conduct of archery. ✻

Yes No

Parent's Name: ✻

Parent's Phone#:

Please enter in the format of 000-000-0000 ✻

Parent's Email Address: ✻

Parent: Are you an enrolled 4-H adult volunteer who is available/interested in chaperoning for 2 or more nights at camp? (Priority will be given to chaperones staying 4 or 5 nights.) Apply as a chaperone.

Remember, you must already be an enrolled adult volunteer to attend the overnight camp. Please email your county 4-H office if you need enrollment information. ✻

Yes No

Our goal is to be proactive and to ensure every camper feels welcome, included, and safe. Please answer the following questions to the best of your ability

Not including this year, how many times has this camper been to 4-H Camp? (the overnight Camp, not the Clover Day Camp)
Please select. ✻

First time Twice Three or more times

Is there anything about your child that you would like us to know?

(e.g. considerations, support requests, preferred pronouns, lodging requirements) ✻

What concerns, if any, does your child have about going to camp? ✻

Do you have any suggestions on how to handle your child’s concerns? ✻

Does your child have any physical, emotional, or mental healh conditions that the camp nurse should be made aware of? ✻

For the camp kitchen:Does the registering camper have any dietary needs or allergies? ✻

Dairy Allergy Egg Allergy Gluten Allergy Celiac Nut Allergy Vegetarian Vegan Other

Are there any other dietary needs you would like the camp cook to know about?

Are there any other concerns you would like us to know?

It is important that we have reliable emergency contact information during camp.

In the event of any illness, event, or medical need, we will first attempt to reach the parent/guardian.

The emergency contact number you provide below will be the secondary contact for any notifications.

Name of secondary emergency contact (NOT parent listed above) ✻

Secondary emergency contact phone number:

Please enter in the format of 000-000-0000 ✻

Medical Treatment Authorization Forms -

It is not required that you provide a paper Medical Treatment Authorization Form.

PLEASE DO check that the camper's ZSuite enrollment profile is up to date and current with any changes in the camper's medical information.

These online forms will be printed and provided as a resource to the health officer for 4-H Summer Camp. Upon check-in at camp, you will be asked to verify and confirm the information on the printed medical form.

Is this applicant a Santa Clara County member, eligible and applying for financial aid?

To determine eligibility for a reduction of the fee, please indicate if:

» Monthly household cash income is at or below 185% of the Federal Poverty guidelines. If your child is eligible for/enrolled in free or reduced-price school breakfast or lunch you meet this criteria. ✻

Yes No

The 4-H Camp fee includes all lodging, meals, snacks, activities and a camp T-shirt.

One Camper = 460.00 per camper
One Santa Clara County 4-H Camper that has applied for financial aid fee waiver = 230.00
One previously awarded "Happy Camper Award" or credit balance available from 2024 = $00.00
Not (yet) 4-H enrolled = 600.00 per camper (fee will include 4-H enrollment), contact Zubia for enrollment info, zmahmood@ucanr.edu
Chaperones, 2024 Happy Camper Award winner and Youth Directors will attend free of charge.
San Benito County members will pay 0.00, the balance will be billed separately, confrim your participation with Julie jkatawicz@ucanr.edu
Santa Cruz County members will pay 210.00, the remainder will be billed separately. Confirm your participation with Julie jkatawicz@ucanr.edu

NOTE: Enter the amount without a dollar sign -- If you are having trouble with credit card processing, please view this Credit Card Processing Help Guide.

To pay online by Credit Card: Enter the appropriate amount of the registration payment in the space here:

NOTE: Enter the amount without a dollar sign -- If you are having trouble with credit card processing, please view this Credit Card Processing Help Guide. ✻

required charge

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