Health Form - Missouri 4-H - University of Missouri - 4h missouri 2026

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  1. Click ‘Get Form’ to open the Health Form in the editor.
  2. Begin by filling out the event details, including the name and date(s) of the event. This information is crucial for proper identification.
  3. Next, provide personal details about the youth, such as their name, gender, birth date, and age. Ensure accuracy for effective communication.
  4. Complete the parent/guardian section with contact information including home phone, work phone, and cell phone. This ensures you can be reached in case of emergencies.
  5. Indicate whether your child has health insurance and provide relevant details like the insurance company name and policy number.
  6. Address any medical needs by answering questions about medications, allergies, special needs, and dietary restrictions. This helps ensure your child's safety during the event.
  7. Fill out emergency contact information accurately to facilitate quick responses if needed.
  8. Finally, review all sections for completeness before signing. Both youth and parent/guardian signatures are required for submission.

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The Key Award is the highest honor and most prestigious award a Missouri 4-H member can achieve. The Key Award recognizes extraordinary service and leadership that goes above and beyond expectations, exemplifying the true spirit of 4-H.
Missouri 4-H Our mission: Engaging youth as valued, contributing members of their communities in partnership with caring adults. Our vision: A world in which youth and adults learn, grow, and work together for positive change.
Notice to Employer: Within 20 days of hiring a new employee, a copy of the Employees Withholding Certificate (Form MO W-4) must be submitted by one of the following methods: Email: withholding@dor.mo.gov Fax: 877-573-6172 Mail to: Missouri Department of Revenue P.O.

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4-H welcomes all Missouri youth. As Americas largest youth development organization, 4-H offers youth, families, and adult volunteers of all ages many ways to engage, grow and serve through clubs, camps, contests, conferences, special interest groups, in-school and afterschool programs, and more.
All youth ages 5-18 can become a Missouri 4-H member.

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