2007 4-H Becoming Leaders of Tomorrow Conference (BLT) Registration
 November 16-18, 2007
 If your age will be 12, 13 or 14 on December 31, 2007, you can go to BLT Camp.
Send completed forms to the county 4-H office by October 26, 2007.
Registration will close on October 26, 2007.
After October 27, 2007, only substitutions of the same gender are allowed.
A completed Code of Conduct and Medical Treatment Form must also be submitted.
For more information, visit http://www.oc4h.org/camp/blt, or call 714-782-7868

Club Affiliation:
Applicant Name:
Parent or Guardian:
Address:
City/Zip:
Area Code and Phone Number:  (        )
If you give us your email address we will send you an email confirmation:
Date of Birth:

Age on December 31, 2007:  12       13      14
 (Please circle)
Grade Completed June 2007: Gender:          Male          Female
Special Needs
Delegate Type:
(      ) Youth
(      ) TLAW

(      ) All Star
(      ) Adult 4H Leader/Chaperone
(      ) Other _________________

Our Council Treasurer will use the following guidelines for issuing refunds:

Canceling prior to the event's sign-up deadline will receive a full refund.
Canceling after the event's deadline will receive a refund if we can fill the space with the same gender.
Event no-shows are not entitled to receive a refund.  If you need to cancel, please do so as early as possible.
Check in and check out procedure:  Upon arriving youths are to be checked in by the responsible adult, and upon leaving, youth are to be signed out.  Medications are, also, to be checked in and checked out.
Sorry, transportation is not provided.  Parents are responsible for getting youth to and from this event
Checks payable to: OC 4-H Council
Parent/Guardian Signature: Mail to:  OCCE 4-H Office
             Attention:  BLT Conference
             1045 Arlington Drive
             Costa Mesa, CA  92626