4-H Eligibility Form

Declaration of Eligibility
In accordance with the Texas Education Agency and University Interscholastic League Side-By-Side Eligibility for Extracurricular Activities guidelines, 4-H members must be academically eligible to participate in 4-H sponsored competitions. As in the past, to satisfy the certification of eligibility of a 4-H member, we will be utilizing the Texas AgriLife Extension Service DECLARATION OF ELIGIBILITY FORM. As a reminder, the proper steps to follow when completing this form are as follows:

  1. The 4-H member and parent should complete the top portion of the form FIRST. Please indicate if eligibility information only is being requested OR if eligibility and an excused absence is also being requested. The name of the 4-H activity and date(s) MUST be completed. Additionally, a parent’s signature is REQUIRED prior to sending the form to the Extension Office for 4-H member certification.
  2. Once the Grimes County Extension Office receives the form with the top portion completed, we will confirm that the 4-H member in question is currently enrolled on 4-H Connect. If the member is not currently enrolled, they will be contacted and asked to complete this task PRIOR to a County Extension Agent signing the form and certifying the member as a bona-fide member of the Grimes County 4-H Program. NOTE: We must follow this procedure simply because the 4-H member must be current with enrollment for it to meet TEA/UIL criteria concerning no pass; no play guidelines.
  3. Following the completion of the top two (2) portions of the form, we will forward it to the 4-H member’s respective school for the principal to complete the eligibility portion of the document. Once we receive the completed document back from the school, we will forward the 4-H family a copy and we will retain a copy for our records.

ALL COMPLETED ELIGIBILITY FORMS WILL BE RETAINED BY THE GRIMES COUNTY EXTENSION OFFICE DURING THE CURRENT 4-H YEAR. ONCE THE CURRENT 4-H YEAR IS COMPLETE ON AUGUST 31ST, ALL FORMS WILL BE DESTROYED AND A NEW 4-H YEAR WILL BEGIN.

Click here to access the fillable form:
17-18 Eligibility Form

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