2026 4-H Summer Camp in Felton, Youth Camper and Youth Staff Registration

✻ = Required

You are completing a WAITLIST REGISTRATION.

As of April 21st, space at 4-H Camp in Felton is full.

If you would like to be on the waitlist, complete the registration and DO NOT pay the fee.

If a space becomes available, we will provide you with a link to submit the camp fee and confirm attendance.

Camper's First Name: ✻

Camper's Last Name: ✻

Best email address for all notices: ✻

What will the camper's age be on June 21, 2025?

✻

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;

(c) The air gun which is furnished to the above named minor shall be in good working order;

(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;

(c) The bow and arrow which is furnished to the above named minor shall be in good working order;

(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 or staffer = 490.00 per camper
One Santa Clara County 4-H Camper or staffer that has applied for financial aid fee waiver = $245.00
Not (yet) 4-H enrolled = 590.00 per camper (fee will include 4-H enrollment), contact Zubia for enrollment info, zmahmood@ucanr.edu
Chaperones, 2025 Happy Camper Award winners and Youth Camp Directors will attend free of charge.
San Benito County members will pay 0.00, the balance will be billed separately, confirm your participation with Julie jkatawicz@ucanr.edu
Santa Cruz County members will pay $290.00, the balance 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.

This is a WAITLISTED registration.

Do not pay unless you have been notified we have space and have been instructed to submit the payment.

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

Survey Verification✻

For verification that you are human, please enter the following code in the box below:
VQMGWL

(if the code is not entered correctly, the survey will not be submitted)

2026 4-H Summer Camp in Felton, Youth Camper and Youth Staff Registration

2026 4-H Summer Camp Santa Clara County

WAITLIST REGISTRATION

You are completing a WAITLIST REGISTRATION.

Medical Treatment Authorization Forms -