Shooting Sports Schedule for 2018 ARCHERY Fish and Game Club RIFLERY / PISTOL Center Target and Fish and Game Club SHOTGUN Clay County Sportsmans Club FEB 17 SIGNUPS(Ext. office) 10 am MARCH 3 SIGNUPS(Ext. Office) 10 am FEB 17 SIGNUPS(Ext. office) 10 am MARCH 3 SIGNUPS(Ext. Office) 10 am FEB 17 SIGNUPS(Ext. office) 1:00pm MARCH 3 SIGNUPS(Ext. Office) 1:00pm MARCH 17 Extension office 10 am MARCH 17 Extension office 10 am MARCH 17 Extension office 1:00pm MANDATORY SAFETY TRAINING AND CLUB SETUP MANDATORY SAFETY TRAINING AND CLUB SETUP MANDATORY SAFETY TRAINING AND CLUB SETUP MARCH 31 Practice at Range 10:30 am MARCH 31 Practice at Range 9:00 am MARCH 31 Practice at Range 1:00pm APRIL 14 Practice at Range 10:30 am APRIL 28 Practice at Range 10:30 am MAY 12 Practice at Range 9:00 am MAY 19 Practice at Range 9:00 am JUNE 9 Practice at Range 9:00 am JULY 21 Practice at Range 9:00 am AUG 11 Practice at Range 9:00 am AUG 25 Practice at Range 9:00 am Archery will be shot at the Laurel County Fish and Game Club: At the intersection of 192 and East 80 Turn onto East 80. Go approximately 2 miles and turn left onto Sally's Branch Road. The next turn will be on the left with a sign that says Fish and Game Club. ALWAYS AT TIMES LISTED ABOVE! APRIL 14 Practice at Range 9:00 am APRIL 28 Practice at Range 9:00 am MAY 12 Practice at Range 9:00 am MAY 19 Practice at Range 9:00 am JUNE 9 Practice at Range 9:00 am JULY 21 Practice at Range 9:00 am AUG 11 Practice at Range 9:00 am AUG 25 Practice at Range 9:00 am Riflery and Pistol will start the season out shooting at the Center Target Firearms and Range. 607 Don s Dr London. (606)260-8822. It will also shoot there on rainy days. Starting May 12 Riflery and Pistol will be shot at the same location as Archery at the Laurel County Fish and Game Club. Look under archery for directions. APRIL 14 Practice at Range 1:00pm APRIL 28 Practice at Range 1:00pm MAY 12 Practice at Range 1:00pm MAY 19 Practice at Range 1:00pm JUNE 9 Practice at Range 1:00pm JULY 21 Practice at Range 1:00pm AUG 11 Practice at Range 1:00pm AUG 25 Practice at Range 1:00pm Shotgun Discipline will be at the Clay County Sportmans Club: Take HWY 472 approximately 13 miles to JL Hughes Rd on right. There will be a sportsman club sign turn right here and follow signs. ALWAYS AT 1:00 PM!!! ALL CLUB MEMBERS WILL BE REQUIRED TO ATTEND CLUB MEETINGS 9 AM AT EXTENSION OFFICE OR FORFEIT SHOOTING RIGHTS THAT DAY! CLUB MEETING DATES IN RED AND WILL MEET AT THE EXTENSION OFFICE FIRST!
Laurel County 4-H Member Enrollment Form Club Name: Date: School: Teacher: Grade: Club Member Information First Name: Last Name: Birthday: Age: Phone Number: Address: City: State: Zip Code: Email: Gender: (check one) Female Male Where do you live?: (check one) Farm - You live on a farm where you raise livestock (cows, horses, goats, etc.) or grow crops In Town - Less than 10,000 people live here, usually in or around the downtown area Outside of Town - Between 10,000-50,000 people live in this area What s your ethnicity?: White Black Hispanic Asian American Indian Hawaiian & Pacific Islander Do you require an accommodation for a disability to participate in this program? Yes No Parent/Guardian Information #1 First Name: Last Name: Cell Phone: #2 First Name: Last Name: Cell Phone: Authorization of Use I, (print full name) hereby grant permission to the University of Kentucky and its affiliates and subsidiaries, including but not limited to the College of Agriculture Cooperative Extension and Agricultural Alumni Association, to interview, photograph and/or videotape me, or my minor child, and/or to supervise and others who may do the interview, photography, and/or videotaping and/or to use and/or permit others to use information from the aforementioned interview and/or the aforementioned images in education and promotional activities for the following without compensation: University Educational Publications/Videos University Promotion/Advertising University Electronics Publishing (e.g. World Wide Web) Local/Regional/National News Media (w/permission of the University of Kentucky) Signature of Parent or Guardian Date:
4-H Participant Information/Enrollment Form (NOT FOR RESIDENTIAL CAMP) Note: 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 be completed, 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 will result in the person being ineligible to participate in 4-H activities. Please print in blue or black ink to allow for photocopying. Name: Last First County/District: Address: Birth date: Age: Youth Female Adult Male City: State: KY Zip: Email: Home Phone: Farm: Yes No Race: Asian White Black American Indian Hawaiian & Pacific Islander Hispanic Non-Hispanic Grade: Emergency Contact #1: Phone H W C Phone H W C Emergency Contact #2: Phone H W C Phone H W C Name of Family Doctor: Doctor s Phone: Health Insurance Company: Policy #: Name of Policy Holder/Relationship to Participant: Member ID: HEALTH HISTORY Does 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 the number 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 be kept confidential. Yes No 1) 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 child without contacting me: Antihistamine Pill Antacid Ibuprofen (Advil) Hydrocortisone Cream Acetaminophen (Tylenol) Decongestant Dramamine Polysporin (topical antibiotic) MEDICAL TREATMENT All information provided on this form is correct and complete to the best of my knowledge. This person has permission to engage in all events and activities. I hereby give permission to the event designee to provide routine health care, administer prescription and over the counter medications as noted 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, including hospitalization. SIGNATURE OF PARENT/PARTICIPANT: DATE: PUBLICITY RELEASE I hereby grant the 4-H program, University of Kentucky and their agents, the right to use, reproduce, assign and/or distribute still pictures, video and sound recordings of myself or my minor child without compensation for use in promotion, advertising, educational publications or online content. SIGNATURE OF PARENT: NO, I do not permit. Revised 1/12/2016
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 and adhere to this Code of Conduct. A 4-H member may be prohibited from participating in a specific event/program if the participation by the individual 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 be in appropriate dress. Dress codes will be specific to individual events. Delegation chaperones and/or volunteers are responsible 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 the participant by a licensed physician) are strictly prohibited. Delegation chaperones and/or volunteers shall limit use of tobacco products 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 shall not be tolerated. Bullying and harassment can 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 program and 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 adult shall accompany a 4-H member any time he/she leave the grounds. Adults shall notify another adult in the delegation before leaving the grounds. At overnight events, only Conference participants may be in sleeping areas. Lounges or common areas may be used only for 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 in charge of the event. The person in charge of the event shall have the final responsibility for disciplinary action. Failure to comply with the Code of Conduct by 4-H ers and family/friends associated with the 4-H participant may result in penalty, including, but not limited to, the following: Sent home from the activity or event at his/her own expense Barred from participation from future 4-H events Assessed the cost of damages for destruction of property Released to nearest law enforcement authority Termination of 4-H membership I,, 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. Member/Volunteer Parent/Guardian County Date
Laurel County 4-H Shooting Sports Discipline Registration Form Club Year 2018 Fees for RIFLERY, ARCHERY and SHOTGUN will be as listed below, per discipline, per member, for the shooting year. Tournament entry fees will be extra, depending on the particular 4-H Area conducting that shooting event! State Competition fees will also be extra and will be paid to the State Office. Members may participate in more than one shooting discipline as long as space is available. Please understand that scheduling conflicts may be a problem at times for members who choose to participate in more than one discipline. Meetings are contingent upon the availability of VOLUNTEER Coaches. Meetings can not be conducted without UK Certified Coaches in attendance. Please complete the following information and submit this form, along with the 4-H enrollment form and applicable fees to the Laurel County Extension Office. Membership and participation numbers may be limited by coach/ member ratios, range availability, and meeting schedules! Upon receipt of this form, 4-H enrollment forms, and applicable fees you will be enrolled as a Laurel County 4-H Sharpshooter member. Please check ALL signature spaces to ensure that they have been signed; vacant signatures will delay membership enrollment. I wish to participate in the following shooting sports discipline(s): check here: [].22 RIFLE and/or {} PISTOL (age restrictions on pistol) [] ARCHERY [] SHOTGUN Name of Youth: PHONE Parent/Guardian: EMAIL:
University of Kentucky 4-H Shooting Sports Waiver Form Supervision of this program is under the direction of the University of Kentucky Cooperative Extension. All participants are responsible for their conduct to UK Extension personnel, to 4-H Leaders, and to other persons supervising this program. I, the undersigned parent or guardian of the participant named below recognize the dangers present in the shooting sports disciplines such as archery, rifle, shotgun, and pistol and their activities. (Circle disciplines that apply) I believe the Laurel County 4-H Shooting Sports Leaders and their assistants are dependable and reliable and will provide safe experiences. I understand that during the course of shooting sports trainings, and events that it may be necessary to position my child to demonstrate such topics as proper stance or correct shooting positions. I hereby grant permission for my child to participate in the shooting sports program, or event. I knowingly and freely assume all such risks, for example: bodily injury as well as loss or damage to property. I understand as the parent/guardian signing this form that I will be held financially responsible for any expenses above and beyond what the 4-H insurance will pay. I assume all risks involved while using equipment supplied in this program. Participants are responsible for their own equipment. I authorize the use of photographs or video of my child, family, and myself while attending or participating in the shooting sports programs or events for educational or media purposes. I grant the University of Kentucky and the Laurel County Extension office the right to use, publish, and copyright my image (including audio, video, or photograph) for educational programs, websites, and promotion of UK/4-H programs. I have read and reviewed the safety rules, range etiquette, behavior guidelines, and discipline specific rules for archery, rifle, shotgun, and pistol. (applicable as noted above) This is to certify as parent/guardian of this participant, I do consent to his/her release of the 4-H volunteers, other participants, UK and it s staff, donors, and the other organizations providing and/ or sponsoring the range/ meeting facilities and/or organizations volunteers and equipment from any and all liabilities to his/her involvement in the 4-H Shooting Sports Program. Parent/Guardian Signature Date Participant Signature Date 4-H Shooting Sports Code of Ethics and Conduct As a participant you have the responsibility of representing the State of Kentucky 4-H program to the public, so you are expected to conduct yourself in a manner that will bring honor to you and your family, as well as to 4-H as a whole. A complete 4-H shooting sports program must convey life skills development and be presented in such a way that is safe, technically competent, and helps instill 4-H values in participants through teaching and example. Certified Shooting sports instructors, Volunteers and parents must be cognizant of their role as a moral and ethical mentor, as well as teacher, to youth and adults in their state and community. Youth must be cognizant of their role to be positive peers within these programs. As a 4-H Shooting Sports Instructor, Volunteer, Parent or Participant: I will respect the participants, volunteers and property associated with the 4-H Shooting Sports Program. I will set a good example as a mentor and role model for 4-H Shooting Sports youth and volunteers. I will conduct myself in a professional and ethical manner while attending a shooting sports event. I will strive to be knowledgeable of the life skills embodied in the 4-H Shooting Sports program and aid positively in the development of youth as well as adults through adherence to those principles. I will strive to be technically competent in the shootings sports disciplines that I participate in and follow the approved 4-H Shooting Sports guidelines. I will respect the dignity of each participant in the 4-H shooting sports program regardless of gender, origin, ability, achievement or conviction. Volunteer/ Parent/Guardian Date Participant Date
YOUTH HANDGUN SAFETY ACT NOTICE (1) The misuse of handguns is a leading contributor to juvenile violence and fatalities. (2) Safely storing and securing firearms away from children will help prevent the unlawful possession of handguns by juveniles, stop accidents, and save lives. (3) Federal law prohibits, except in certain limited circumstances, anyone under 18 years of age from knowingly possessing a handgun, or any person from selling, delivering, or otherwise transferring a handgun to a person under 18. (4) A knowing violation of the prohibition against selling, delivering, or otherwise transferring a handgun to a person under the age of 18 is, under certain circumstances, punishable by up to 10 years in prison. FEDERAL LAW The Gun Control Act of 1968, 18 U.S.C. Chapter 44, provides in pertinent part as follows: 18 U.S.C. 922(x) (x) (1) It shall be unlawful for a person to sell, deliver, or otherwise transfer to a person who the transferor knows or has reasonable cause to believe is a juvenile-- (A) a handgun; or (B) ammunition that is suitable for use only in a handgun. (2) It shall be unlawful for any person who is a juvenile to knowingly possess-- (A) a handgun; or (B) ammunition that is suitable for use only in a handgun. (3) This subsection does not apply to-- (A) a temporary transfer of a handgun or ammunition to a juvenile or to the possession or use of a handgun or ammunition by a juvenile if the handgun and ammunition are possessed and used by the juvenile- (i) in the course of employment, in the course of ranching or farming related to activities at the residence of the juvenile (or on property used for ranching or farming at which the juvenile, with the permission of the property owner or lessee, is performing activities related to the operation of the farm or ranch), target practice, hunting, or a course of instruction in the safe and lawful use of a handgun; (ii) with the prior written consent of the juvenile s parent or guardian who is not prohibited by Federal, State, or local law from possessing a firearm, except-- (I) during transportation by the juvenile of an unloaded handgun in a locked container directly from the place of transfer to a place at which an activity described in clause (i) is to take place and transportation by the juvenile of that handgun, unloaded and in a locked container directly from the place at which such an activity took place to the transferor; or (II) with respect to ranching or farming activities as described in clause (i), a juvenile may possess and use a handgun or ammunition with the prior written approval of the juvenile s parent or legal guardian and at the direction of an adult who is not prohibited by Federal, State or local law from possessing a firearm; (iii) the juvenile has the prior written consent in the juvenile s possession at all times when a handgun is in the possession of the juvenile; and (iv) in accordance with State and local law; (B) a juvenile who is a member of the Armed Forces of the United States or the National Guard who possesses or is armed with a handgun in the line of duty; (C) a transfer by inheritance of title (but not possession) of a handgun or ammunition to a juvenile; or (D) the possession of a handgun or ammunition by a juvenile taken in defense of the juvenile or other persons against an intruder into the residence of the juvenile or a residence in which the juvenile is an invited guest. (4) A handgun or ammunition, the possession of which is transferred to a juvenile in circumstances in which the transferor is not in violation of this subsection shall not be subject to permanent confiscation by the Government if its possession by the juvenile subsequently becomes unlawful because of the conduct of the juvenile, but shall be returned to the lawful owner when such handgun or ammunition is no longer required by the Government for the purposes of investigation or prosecution.
Laurel County 4-H Shooting Sports Name of Member(s) Date of Birth / / / / / / This is to certify I am the parent or guardian of (Members Name) In accordance with Federal Law 18 U.S.C. 922 (X) (3) (A) this constitutes my prior written consent for the above named member to have temporary possession of a.22 Cal. Handgun for use in 4-H safety instruction, 4-H target practice, and 4-H competition as well as transportation of the unloaded handgun to and from these activities. The above consent expires December 31, 2018. (Signature of Parent or Guardian) (Signature of Witness) Attached: Copy of YOUTH HANDGUN SAFETY ACT NOTICE I have read the Enclosed Law: (Signature of Parent or Guardian) / / (Date) Copy on File in the County Extension Office Educational programs of the Kentucky Cooperative Extension Service serve all people regardless of race, color, age, sex, religion, disability, or national origin.
Family Face Sheet Laurel County Sharp Shooters 2018 Child s name: Child s Date of Birth: Parents: Address for Family: 2 contact phone numbers: Do you wish to purchase team shirts ($12 each) Y N Please include sizes for each shirt you wish to purchase: (Note: these shirts will be worn to our competitions and community events) Siblings also enrolled in the program: Allergies: We try to provide snacks and drinks while we are on the ranges as they are available. If any member of your family has food allergies please list them here: One guardian will need to designate themselves as a potential volunteer for district and state competitions. Without the required number of volunteers students will not be able to participate in these events. Volunteer Phone Phone Please always feel free to provide us valuable feedback on the experience you and your child have with this program. Making the Best Better is our Motto but we can only do that with you.
LAUREL COUNTY 4-H SHOOTING SPORTS RULES 1. 4-H participants must display courteous and respectful behavior toward coaches, other participants, and parents during meetings, events, and while representing 4-H. 2. A parent or guardian must attend all meetings with 4-H members. Be prepared to show Photo I.D. for admission to the fish/game club. 3. All safety equipment must be worn by members at all times while on active lines. Safety glasses and hearing protection are REQUIRED for range work. 4. Firearms and equipment must be in safe working condition and comply with the most current KENTUCKY COMPETITIVE 4-H SHOOTING SPORTS RULES. 5. All firearms must be transported unloaded, action open, and cased at all times. Firearms will remain cased until otherwise directed by coaches and/or Safety Range Officers. Clear bore indicators shall be used as directed by coaches. 6. Range rules and commands given by the certified coaches must be followed by members and parents/guardians at all times. 7. Members must be at least 9 years of age, and no more than 19 years of age by January 1 st of the current club year. Cloverbud members ages 7 or 8 years of age may participate in Archery pending the approval of the coaches. 8. Members may be removed from the range or the club for blatant disregard for safety Rules and general rules during 4-H Shooting Sports events. (Refer to By-laws) 9. If a member desires to attend the State 4-H Shooting Sports Competition he/she will be required to: a. attend at least ½ of the regularly scheduled club meetings (members are responsible for signing-in at meetings in order to be counted) b. Participate in (1) Community service project per year (1) Fundraising Event per year c. All returning members are strongly encouraged to attend one district/regional shooting match as preparation for state competition. d. First year members are required to attend one district competition before registering for state competition. e. All guardians of district or state participants are expected to volunteer for these events if necessary. 10. Non-Shooting Sports members will not be permitted to handle firearms or archery equipment during club meetings or permitted to be in or near the designated shooting area without the express permission of the designated coach or safety range officer. 11. All club fees are due when enrollment forms and paperwork are turned in at the county extension office. 4-H Shooting Sports Member Parent or Guardian PHONE
Laurel County 4-H Shooting Sports Dress Code **There is a great possibility that we will have media coverage for portions of the 2016 Range practices, District Competitions and State Competition. The dress code is going to be strictly enforced so we sincerely request your cooperation. In the interest of safety and promoting the positive values and image of 4-H, the following will pertain to the youth as well as all members, coaches, parents and volunteers of the 2018 Laurel County Shooting Sports Club. Dress code expectations: Participants are expected to dress appropriately for the events in which they will participate. Team shirts are encouraged at district and state events, but not required. Both young people and adults should wear attire appropriate for the weather while remaining modest and socially acceptable. Clothing with sexually-suggestive wording or graphics; gang, violence or terrorist references; and alcohol or tobacco advertisement is not appropriate. Excessively tight or baggy clothing is prohibited. Excessively baggy (or loose) clothing includes any pants or shorts whose waistband is below the waistline. (example: saggy pants/shorts) These items are a potential safety hazard while equipment. working around Items of clothing which expose bare midriffs, bare chests, undergarments or that are transparent are prohibited. Shorts are acceptable, but must be at least as long as the youth s fingertips when their arms hang comfortably at their side. Tank tops and sleeveless shirts are not permitted at shooting events. Shirts which expose the bare back, halter tops and tube tops are prohibited. Appropriate undergarments are required. Shoes appropriate for the specific event are required; flip-flops, sandals, open-toed shoes, slippers, high heels and platform shoes are prohibited at shooting events. Shoes must be fastened for a secure fit. Approved safety glasses must cover the entire eye area. If prescription glasses are worn, the lenses must be ANSI Z87.1 compliant and must also cover the entire eye area. If prescription glasses do not meet the above requirements, safety glasses shall be worn over them. These guidelines are in place for the safety of all members. Range officials have the final word concerning the dress code and may announce or address specific cases. All participants and coaches should remember that they may be having photographs taken or be asked to interview for the media. Remember that you represent all of 4-H Shooting Sports. Make it a positive image! For District, State and National 4-H competitions, refer to those specified rules for more-detailed dress codes; they may overlap or supersede club rules.
UNIVERSITY OF KENTUCKY, KENTUCKY STATE UNIVERSITY, U.S. DEPARTMENT OF AGRICULTURE, AND KENTUCKY COUNTIES, COOPERATING 2018 Shooting Sports Awards Participation Award Perfect Attendance Award Most Improved Award (per category and discipline) # of Years Award Project Book Awards Robin Hood Award Best Score at District Event Award (per discipline) Best Score at State Event Award (per discipline) Best Adult Shooter/Score Award Best Youth/Adult Score Award Best Sport Award