DATE: March 1, 2022 - Mccracken.ca.uky.edu

DATE:March 1, 2022TO:2022 4-H Hot Shot ParticipantsFROMCaleb Bell, McCracken County 4-H Youth Development AgentWe are excited for your interest in such a terrific 4-H program. Over twenty years ago, we beganwith only 10 members. Now, the McCracken County Hot Shots has grown to over 100 membersevery year! Through our dedicated and certified volunteer coaches, we are able to offer thefollowing disciplines: Rifle (.22, air, bb)Pistol (.22, air)TrapArcheryEach year, these coaches donate over 100 hours of their time to make this program such a success.Through their coaching and leadership, members are developing not only their shooting skills andknowledge, but skills in areas of leadership, discipline and self-confidence.RETURNING MEMBERS: Early registration for returning members opens March 17th.You can register on-line at ts or at the office.ABSOLUTE LAST DAY TO REGISTER IS MARCH 31st.NEW MEMBERS: Sign ups will be held at the extension office on Thursday, March 31st at 6:00S P for both parent/guardian and youth.For instant updates on schedules, practices and matches, makes sure to install Team Reach.Information is included in packet.We are always seeking more adult leaders. There are several ways to get involved with the program.If interested, please contact me at 270-933-1381 or 270-554-9520 or by email atcaleb.bell@uky.edu.

2022McCrackenCounty4-HHotShots ShootingSports ClubNameNEW MEMBERDues: 65.00 Please make checks payable to:McCracken County 4-H CouncilPlease put your child’s name on the memoRegistration and a mandatory meeting will be held at the McCrackenCounty Cooperative Extension Service on Thursday, March 31st at6:00 p.m. for all new members.Trap participants will have to bring own shells or purchase shells at the range. NO RELOADS ALLOWEDStaffUseOnlyDuesTest

20224-HHotShotsEnrollmentNew:Date :FirstName:M:Returning:Last Name:Address:City:State:Phone:- -Age:T-Shirt Size:Zip:Email:(ChildMUSTBE9asofJanuary1,2022 NOEXCEPTIONS)(Choose one)YouthAdultSSMMLLXLXLXXLNew members - rank up to two disciplinesReturning members - rank up to four disciplinesRank disciplines 1 (first choice) up to 4 (last choice)Only rank disciplines you are interested in.RiflePistolShotgunArchery*** Please note that for Rifle and Pistol there is alimit of 20 participants for each with prioritygiven to returning members.***

Permission to ParticipateMcCracken County Hot Shots 4-H Shooting Sports rintheHotShots4-HShootingSportsProgramon1/1/22 - 12/31/22.I am alsoaware that as a parent/guardian I will be responsible for volunteering for at least 2 local matches. If mychild participates in the Kentucky State Shoot in September I will be responsible for volunteering for aminimum of 2 nginthe 4-H shooting sportsprogram is voluntary and is not required for being a 4-H member.Iamawareandhavediscussedwithmychildthat:a. rytoanotherpersoninsafetyrules arenotfollowed.b. rwisemayresultinharmtomychild.c. mtomy child.d. rdsarisingfromfirearmsequipment.e. horizedsuchexpenses.Parent/Guardian’s Signature4-HMember’sSignatureDateDate

InsertPhotoHere4-H Participant Information/Enrollment Form(NOT FOR RESIDENTIAL CAMP)2021-2022Note: The form must be completed by the participant and/or parent or guardian in order to participate in the 4-H program. All items must becompleted, even if the response is not applicable – indicate by using N/A (i.e. no health insurance). Failure to complete this form in its entirety willresult in the person being ineligible to participate in 4-H activities. Please print in blue or black ink to allow for photocopying.Name:Address:Birth date:State: KY hAdultAge:FemaleMalePhone:Participant Email:School Name: Grade: Primary 4-H Club:Residence:FarmRural/10,000Town 10,000 City 50KOver 50,000Ethnicity: Hispanic Non-HispanicRace: Asian White Black American Indian Hawaiian & Pacific IslanderParent/Guardian Contact #1: Phone HWMilitary Family: No Active Reserve Branch:CPhone HCWParent/Guardian Email:Emergency Contact #2: Phone HWCPhone HWCName of Family Doctor:Doctor’s Phone:Health Insurance Company:Policy #:Name of Policy Holder/Relationship to Participant:Member ID:HEALTH HISTORYDoes the participant have, or at any time has had, any of the following? Check “Yes” or “No” to each item. Please explain any “yes” answers (noting thenumber of the item) in the space below or on an additional sheet if necessary. Reporting conditions will not prevent a person from attending and will bekept confidential.Yes No1) Asthma 2) Bronchitis 3) Convulsions .4) Diabetes 5) Ear Infection .6) Fainting .7) Heart Condition 8) Headaches 9) Hypoglycemia .10) Serious Allergy to Insects . 11) Wear Glasses/Contacts 12) Other Conditions 13) Drug Allergy (please explain) 14) Food Allergy (please explain) 15) Other Allergy (please explain) .Please Explain Any “Yes” Responses:List and explain any restrictions (dietary, physical, etc):The following over the counter medications may be administered to my childwithout contacting me:Antihistamine PillAcetaminophen (Tylenol)AntacidDecongestantIbuprofen (Advil)DramamineHydrocortisone CreamPolysporin (topicalantibiotic)MEDICAL TREATMENTAll information provided on this form is correct and complete to the best of my knowledge. This person has permission to engage in all events andactivities. I hereby give permission to the event designee to provide routine health care, administer prescription and over the counter medications asnoted and seek emergency medical treatment if warranted. I agree to the release of all records necessary for medical treatment, billing or insurance.In the event I cannot be reached in an emergency, I give permission to the attending physician to secure and administer treatment, includinghospitalization. SIGNATURE OF PARENT/PARTICIPANT:DATE:PUBLICITY RELEASEI hereby grant the 4-H program, University of Kentucky and their agents, the right to use, reproduce, assign and/or distribute still pictures, video andsound recordings of myself or my minor child without compensation for use in promotion, advertising, educational publications or online content.SIGNATURE OF PARENT/PARTICIPANT:NO, I do not permit.Revised 9/28/2017Revised by McCracken County 9/2021

4-H Youth Development CODE OF CONDUCT FORM (NOT FOR RESIDENTIAL CAMPS)All 4-H members and family/friends associated with 4-H members must respect the individual rights, safety and property of others andadhere to this Code of Conduct. A 4-H member may be prohibited from participating in a specific event/program if the participation by theindividual poses a danger to the 4-H member and/or others. The following guidelines are designed to make all 4-H events safe, meaningful,and satisfying to youth and others attending.WHILE ATTENDING ALL 4-H MEETINGS, PROJECTS, PROGRAMS, ACTIVITIES AND EVENTS: Each 4-H participant is expected to attend all planned sessions, workshops, field trips, and meetings of the event, and to bein appropriate dress. Dress codes will be specific to individual events. Delegation chaperones and/or volunteers areresponsible for ensuring that members participate in all aspects of the planned program activities. The possession and use of alcoholic beverages, tobacco products, and/or drugs (except for medications prescribed to theparticipant by a licensed physician) are strictly prohibited. Delegation chaperones and/or volunteers shall limit use of tobaccoproducts to designated areas. Setting off fire alarms, tampering with fire extinguishing and other emergency equipment are strictly prohibited. Gambling of any type is strictly prohibited. Obscene, discriminatory and/or inappropriate language, roughhousing, and insubordination are prohibited at all times. Respect toward others and facilities shall be demonstrated. Bullying, harassment of others or destruction of property shallnot be tolerated. Bullying and harassmentcan include the use of social media. Display of overly affectionate or inappropriate attention between participants is strictly prohibited. Technological equipment (including but not limited to cell phones, laptops or mp3 players) shall not interfere with the programand may not be allowed in certain situations. Each county may adopt additional Code of Conduct guidelines.WHILE ATTENDING OVERNIGHT CONFERENCES, CAMPS, AND EVENTS, THE FOLLOWING WILL ALSO APPLY: All participants are to be in their assigned area at curfew and comply with quiet hours, lights out, and other rules of the event. No member or volunteer may leave the grounds without the permission of the conference director or adult in charge. An adultshall accompany a 4-H member any time he/she leave the grounds. Adults shall notify another adult in the delegation beforeleaving the grounds. At overnight events, only Conference participants may be in sleeping areas. Lounges or common areas may be used onlyfor working committees and social activities. Room service such as phone calls, food, laundry, or others shall not be permitted without chaperone permission.Any violations of this Code of Conduct shall be reported promptly to the adult in charge of the delegation/program and to the person incharge of the event. The person in charge of the event shall have the final responsibility for disciplinary action. Failure to comply withthe Code of Conduct by 4-H’ers and family/friends associated with the 4-H participant may result in penalty, including, but notlimited to, the following: Sent home from the activity or event at his/her ownexpenseBarred from participation from future 4-H eventsAssessed the cost of damages for destruction of propertyI, Released to nearest law enforcement authorityTermination of 4-H membership, have read the Code of Conduct and agree to abide by its rules.(Print Name)I understand that infraction of this Code of Conduct will result in any or all of the penalties listed above.In the event I received a scholarship or financial assistance to an event and can no longer attend, I am responsible fornotifying my 4-H Agent one week prior to the event and/or finding my own replacement. Failure to communicate with my4-H Agent may result in becoming ineligible for future scholarships and any money paid by participant may be e

McCracken County 4-HHot Shots Shooting Sports Team2022 Safety TestTo be completed by participant. This serves as a pre-assessment of the level ofcomfortability youth have entering the program.Name: Birth Date:1.What does the range command “Cease Fire” mean?a.c.2.Stand up and walk awayStart talking to your friend next to youWhat should you do you if you pull the trigger and your firearm fails to fire?a. Turn around and yell for the coachc. Keep muzzle downrange/raise your hand.3.Baseball cap and Flip-FlopsSafety Glasses and Hearing Protectionb. Mascara and Lip Stickd. Knee and Elbow PadsIf you see someone step out into the open down range, what should you do?a. Turn around and yell for the coachc. Point at them and laugh5.b. Drop the firearm and throw a fitd. Try to find out why and fix it yourselfBefore shooting firearms, what are the two important safety items you must put on?a.c.4.b. Do not fire, await instruction from RSOd. Start listening to your IPodb. Shoot at themd. Call out “CEASE FIRE!”When can you pick up, handle and/or shoot your firearm or bow at the shooting range?a. When you get to the shooting rangec. When you’re instructed to by the RSOb. Whenever you feel like itd. When your Mom or Dad says it’s okay6. In the 4-H Shooting Sports program, what do the letters “M A T” mean to you?a. Muzzle always toward groundc. Most Accurate Targetb. Materials, Ammo, Targetd. Muzzle, Action, Trigger7. Which line on the range separates the shooters from the spectators?a. Target Linec. Firing Lineb. Safety Lined. Forward Line