ST. MARY’S COUNTY 4-H LIVESTOCK REGISTRATION
(Use only for Breeding Swine)
Due in County 4-H Office by July 1of the current year
Please print clearly
Members Name _______________________________
Address: _____________________________________
____________________________________________
Phone: ____________________________
4-H Tag #
Premise/Scrapies
Breed
Tag #
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