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Family Development and Resource Management, Family and Consumer Sciences, Texas Cooperative Extension, The Texas A&M University System

4 H Logo   4–H Team Captain Registration
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required information
Team Captain's First Name: 		required information
Choose your County:
required information
Enter Your City:
(i.e. Houston)
 		required information
Enter Your 5-Digit Zip Code:
required information
Enter Your Team Name:
 		required information
Capitain's Password:
required information
Team Captain's Gender:
Female    Male 		required information
Team Captain's Age:
years
Team Captain's Ethnic Background:

Anglo African-American Asian
Hispanic Native American Other (specify)  
Signed Registration Form Submitted to Team Captain:
Yes    No
  Currently, are you physically active at least 30 minutes 5 days a week?
     Yes            No
  How many minutes a day are you physically active at this time?
If you are physically active, which of these fitness activities do you do now? (Check all that apply.)
A. I do no fitness activity now. D. Swim
B. Walk E. Ride bicycle
C. Run F. Other (specify)
Where do you do these fitness activities?   (Check all that apply.)
A. Parks D. Local mall
B. Local gym/fitness center E. School track
C. Home fitness center F.  Other (specify)
 

 

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Educational programs of the Texas AgriLife Extension Service are open to all people without regard to race, color, sex, disability, religion, age, or national origin.

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