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Capitol Corridor, Solano County
University of California
Capitol Corridor, Solano County

4-H Forms

You need to be familiar with the following forms:

Solano County 4-H Incident Report Form 2015-16 (MS Word)
Solano County 4-H Incident Report Form 2015-16 (PDF):
Use this form to report all non-medical incidents that pose health & safety concerns or potential violations of California 4-H Member or Leader Codes of Conduct. (Click on one of the underlined links to view the form.)


Adult Treatment Authorization Form 2016-17 7-1-16 (PDF):
All adult volunteers are required to complete this form annually. It is kept on file with the community leader and is treated as confidential information. (Click on one of the underlined links to view the form.)


Youth Treatment Authorization Form 2016-17 7-1-16 (PDF):
All youth members must have a parent/guardian complete this form annually. It is kept on file with the community leader and is treated as confidential information.  (Click on one of the underlined links to view the form.)

4-H volunteers must have current medical treatment forms for all 4-H members before transporting them in personal or commercial vehicles to any 4-H activity or event, including club field trips and activities, and county, regional, or state activities. (Click on one of the underlined links to view the form.)

Accident Insurance Claim Form: (There is no link to this form. It is only available as a hard copy from your community leader or from the UCCE office.) Use this form to report all injuries and medical incidents (both youth & adult). Bring a blank form with you on every 4-H outing or activity. If an injury occurs, immediately complete section II of the claim form and call the UCCE office to report the incident.

Webmaster Email: jmbaumbach@ucanr.edu