4-H Office Use Only
Date Received:
MARYLAND 4-H CLUB
HORSE AND PONY
IDENTIFICATION CARD
Member Identification
Name ______________________________________________ Birthdate ____________________________________________
Address _________________________________________________________________________________________________
Club _________________________________________________ Phone ____________________________________________
Project Identification
Name of Horse _______________________________________ Birthdate ____________________________________________
Breed _____________________________________ Sex _________ Height __________________________________________
Does this animal have an official measurement card granted by USAE or an affiliate? _____ YES _____NO (check one)
Color and Markings (be specific) ______________________________________________________________________________
Year(s) that this horse is a project animal
20_______
20_______
20_______
20_______
20_______
Owned _____________________________ Leased* ____________________________ (check one) *Signed agreement on file
Club Member ______________________________________________ Club Leader ____________________________________
Signature
Signature
Parent ______________________________________________________ File with the Extension Educator one card for each
Signature
horse prior to June 1 of the current year.
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provided to UME may be used and shared within UME, the University of Maryland and the University System of Maryland and with outside entities as necessary or appropriate in accordance with applicable
law and the mission, purpose and functions of UME and the University. Because the University is a State educational institution, such information may also be subject to disclosure under the Maryland
Access to Public Records Act. A person may inspect and/or correct his or her personal information as provided by the Maryland Access to Public Records Act and/or applicable University policy Updated
3/2010 for name and logo change..