Registrations | Illinois Extension

Little Sprouts with 4-H and Master Gardeners!

This program will introduce youth to nature and gardening through storybooks and fun learning activities. These sessions explore the hidden world of plant parts and other fun topics such as vibrant vegetables, beautiful butterflies, and amazing apples. Learn, imagine, and grow with us!

10:00 AM to 10:30 AM | Blue Ridge Township Public Library | 116 E. Oliver St. | Mansfield, IL 61854

3:45 PM to 4:15 PM | Goose Creek District Library | 220 N. Hwy | DeLand, IL

All Ages Welcome
An adult accompanying the youth participant must be present.

For questions or to request a reasonable accommodation, please contact Beth Miglin.
**NOTE: You do NOT need to create an Extension User Account to register. Please complete the contact information below.**

Contact Information

First Name

Last Name

Street Address

Street Address 2

City

State

ZIP

Daytime Phone

Evening Phone

E-mail Address

Which program would you like to participate in? *you may select multiple dates

Plant Parts | June 20

[8 of 15 filled]

Plant Parts | June 25

[0 of 15 filled]

Vibrant Vegetables | July 18

[0 of 15 filled]

Beautiful Butterflies | August 29

[0 of 15 filled]

Amazing Apples | September 19

[0 of 15 filled]

Vibrant Vegetables | July 23

[0 of 15 filled]

Beautiful Butterflies | August 27

[0 of 15 filled]

Amazing Apples | September 10

[0 of 15 filled]

Please list the names and ages of all participants attending in your group. *ex.) John Smith - 5 years old

Are you currently a 4-H Member?

Yes, I am.

No, I am not.

If currently a 4-H Member, what club are you in? *if not a member please input N/A

Do you need any support or accommodations to participate in this program? *early requests are encouraged to allow sufficient time for meeting access needs.

Photo/Talent 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. Do you consent to this form?

Yes, I consent.

No, I do not consent.

First and Last Name/Signature of Talent (or parent/legal guardian if under 18): *By entering your name you consent to the release of all video/photo/audio recorded during this program. | If you do not consent, please input N/A.

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