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Animal Care and Housing Form for Colorado 4-H Livestock Projects
It is the responsibility of every 4-H member to ensure that proper care is taken of their animal(s) according to acceptable methods
of good animal husbandry, as set forth by Colorado State University Extension and the Colorado Department of Agriculture. A
healthy animal requires sufficient food, water, shelter, and appropriate health care. Cruel and inhumane training methods are
prohibited in the Colorado State University Extension 4-H Program and will not be tolerated. Specific animal husbandry guidelines
and humane training methods are provided in the appropriate 4-H manual. It is necessary for the local county Extension office to
know the location of all 4-H livestock/horse projects.
The Colorado 4-H current project recommendation for primary care states that “4-H members will provide primary and continuous
care of their project animals.” Primary care is defined as the 4-H member making the decisions for and/or providing thecare, handling, and training of their animal project a majority of the time. Primary care exemption must be approved by the
designated local representative body comprised of at least one Extension agent and other committee representatives as appointed
by the Extension office. The county will determine a one-step appeal process if request is denied.
Each situation for exemption of primary care will be evaluated within the exhibitor’s county by an appropriate review body. An
approval or disapproval of the situation will be communicated to the participant(s) in writing. An appeal may be submitted through
established grievance channels established in each county. 4-H members and guardians acknowledge that approval of facilities and
animal welfare checks may be conducted at anytime by the local county Extension agent.
Submission of this animal care document is required by all 4-H animal project participants each 4-H year. Please check the box for
each species you will be enrolled in this year. Sign and return this form to your county Extension office as a commitment to the
above guidelines.
�� Beef Cattle �� Dairy Cattle �� Goat �� Horse �� Llama �� Poultry �� Sheep �� Swine
�� Dog �� Rabbit �� Other Please check all that apply
Date:______________________________________ 4-H Club: ____________________________________________________
Exhibitor Name:___________________________________________________________________________________________
Physical Address:__________________________________________________________________________________________
City, State, and Zip Code: ___________________________________________________________________________________
Telephone/cell phone number:________________________________________________________________________________
Optional Information: Premises Registration Number with NAIS: ______________________________________________
This section is for animals housed at your home
1. Will all of your animals be housed at your home location?
Yes No
If your answer is No, please answer the following questions on page 2 and list the animal(s) not housed at your home location
and submit to your Extension agent for approval. I grant the Extension agent permission to check on the 4-H member’s animals
while they are housed on my property provided advance notice of such visits are given.
If your answer is Yes, please sign below.
I hereby certify that I have read the above information and will comply with the rules set forth above.
___________________________________________ ___________________________________________________
4-H Member’s Signature Parents/Guardian’s Signature
This section for animals NOT housed at your home
2. List the particular circumstances that prevent you from having your project animals(s) housed at your primary residence.
________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
3. Please indicate where (including address) each animal will be housed and the landlord/caretaker of the residence.
(Horse projects only: �� Check this box if your horse(s) is being boarded and supply the following information.)
Landlord/Caretaker Name:___________________________________________________________________________________
Physical Address:__________________________________________________________________________________________
City, State, and Zip Code: ___________________________________________________________________________________
Telephone/cell phone number:________________________________________________________________________________
Optional Information: Premises Registration Number with NAIS: ______________________________________________
4. How do you plan to care for the project animal(s) not located at your primary residence? What arrangements have you made
for traveling to and from the non-primary residence to care for your animal(s)?
________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
5. If you will not be providing primary care for your project animal(s) during the entire ownership period, please explain who
will be providing primary care, when they will be caring for the project animal, and why you are unable to provide primary
care for the project animal through the ownership period.
________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
6. What 4-H shows do you plan to participate in? You will be under the same primary care requirements at all times. Please list
the shows below:
________________________________________________________________ _______________________________________________________________
________________________________________________________________ _______________________________________________________________
________________________________________________________________ _______________________________________________________________
As the landlord/caretaker of the property listed above, I acknowledge the 4-H program’s intent is educational; as such I will
encourage and require the 4-H member to be extensively and continuously involved in the care of their animals housed at my
property. If deemed necessary by the Extension agent, I grant the Extension agent permission to check on the 4-H member’s
animals while they are housed on my property provided advance notice of such visits are given.
_________________________________________________________________________ ____________________________
Landlord/Caretaker’s Signature Date
I hereby certify that the above information is truthful and accurate.
_________________________________________________ ________________________________________________
4-H Member’s Signature Parents/Guardian’s Signature
_________________________________________________
4-H Leader’s Signature
*Your request for Animal Care Exemption has been: Approved Denied
__________________________________________________________________________ ____________________________
4-H Extension Agent’s Signature Date
Rev: 10.1.07
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