ST. MARY’S COUNTY 4-H LIVESTOCK REGISTRATION (Use only for Breeding Goats) Due in County 4-H Office by July 1 of the current year Please print clearly Members Name _______________________________ Address: _____________________________________ ____________________________________________ Phone: ____________________________ 4-H Tag # Scrapies Breed Tag/Tattoo # Club Name: ___________________________ Sex Bred/ Owned Date Date of or Purchased Purchased Birth My signature indicates that the above animal(s) are under my care, I own them, and I have correctly and honestly filled this form out to the best of my knowledge and that I have completed the Quality Assurance Program. ___________________________________ Member Signature _________________________________ Parent/Guardian Signature ____________________ Date