2026 Teen Weekend Registration Form

Summer Teen Weekend

July 10 - 12, 2026
Name

First NameLast Name
Age
Birth Date

MonthDayYear
Gender
T-shirt Size
County
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail (please list an email you check frequently as this will be our main means of communication)
Phone Number

Area CodePhone Number
Roommate Request (we will do our best to accommodate roommate preferences based on numbers and lodging)

Teen$125.00

Trained AdultFree

Must have all 4-H Online training complete.

Enter coupon

Total $0.00

Virginia Cooperative Extension is a partnership of Virginia Tech, Virginia State University, the U.S. Department of Agriculture (USDA), and local governments, and is an equal opportunity employer. For the full non-discrimination statement, please visit ext.vt.edu/accessibility.

If you are a person with a disability and desire assistance or accommodation, please notify Rayna Wheeler at 540-721-2759 x253/TDD* during business hours of 8:30 AM to 4:30 PM.
*TDD number is 800-828-1120.
Should be Empty:

Summer Teen Weekend