2026 Alameda County 4-H Summer Camp Youth Camper and Youth Staff Registration

Camper's Last Name: ✻

Camper's First Name: ✻

Best email address for all notices: ✻

What was the camper's age be on December 31, 2025?  (4-H age) ✻

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 12, 2026.

A = Adult Size

Y = Youth Size ✻

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

ARCHERY SPORTS PERMISSION -- I do hereby give permission to the Alameda County 4-H Youth Development Program, and to all officers, instructors, and assistants participating in the archery activity at the Alameda 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;

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

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

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 at camp?  The number of chaperones will be limited and based on number of campers. Chaperones will also pay a reduced $100 fee toward food and lodging costs.   You must already be an Active enrolled adult volunteer to attend the overnight camp. Please email the county office if you need enrollment information. 

Apply as a chaperone.

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

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? ✻

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?

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

Secondary emergency contact phone number:

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

CAMPER'S CODE OF CONDUCT - I acknowledge that I have read the Camper's Code of Conduct and agree to follow its rules.  ✻

Is this applicant an Alameda 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.

Please complete the Event Financial Assistance Application. ✻

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.  ✻