Farm Safety Day 2024

Farm Safety Day will be held on Tuesday, June 11, 2024 from 8:30 AM to 1 PM at the Fulton County Fairgrounds in Lewistown.
Safety activities offered will be:

*Poisonous Plants * Fire * Cyber * Livestock * Chemical * Electricity * ATV * Weather

Must be age 6 or older to attend!

All activities are free.
A parent or adult chaperone is encouraged to attend.
Grand Finale will be presented by the Gateway Sled Dog Club and starts at 12:30 PM

A sack lunch (hotdog, chips, cookie, drink) will be available and served at noon. If you have food allergies or would rather have something else, feel free to bring your own sack lunch if you'd like.

Participants registered by May 20 will receive a gift.

Contact Information

First Name

Last Name

Street Address

Street Address 2

City

State

ZIP

Daytime Phone

Evening Phone

E-mail Address

Age of child named above. (must be age 6 or older)

Parent Name(s) and phone number(s) Please be sure your child's name is in the contact information above.

Please list any health issues or allergies.

I understand that although precautions will be taken, the organizers of this event will not be held responsible for accidents, should they occur.

Yes, I agree

No, I do not agree

Please list any emergency contact(s) and phone number(s) for the day of the event.

Photo Release I, the undersigned, do hereby consent to the use by The Board of Trustees of the University of Illinois (University) of my image, voice, or both described below, in (1) the video, photograph, or audio recording described below; and (2) any video, photograph, or audio recording reproduced either in whole or in part from the video, photograph or audio recording described below: regardless of whether these materials are used for fundraising, advertising, publicity, or any other purpose on behalf of either the University or its Foundation. I warrant that I have the full right and authority to grant this consent. In addition, I waive all claims to compensation or damages based on the use of my image or voice, or both, by either the University or the Foundation. I also waive any right to inspect or approve the finished photograph or video or audio recording. I understand that this consent is perpetual, that I may not revoke it, and that it is binding on me, my heirs and assigns. I warrant that I am at least 18 years of age and that I am competent in my own name insofar as this consent is concerned, or that I am the parent or legal guardian authorized to sign on behalf of a person under age 18. I further attest that I have read this consent form and fully understand its contents.

YES

Is there another person attending that we should group your child with? Please provide the name of that person. If not, please just write N/A in the box.

What is your child's shirt size?

Are you currently a 4-H member?

Yes!

No, but I am interested in more information about 4-H

No, and I don't want more information about 4-H

County you live in?

Civil Rights Compliance - Participant Info

As part of our commitment to providing equal opportunities in our programming, University of Illinois Extension is required to collect and report overall statistics about the race, ethnicity, and gender of program participants. Your responses are voluntary and appreciated.

Gender

Ethnicity

Race