2020 SJTC Teen Planning Committee

COUNTY REPRESENTATIVES

Burlington Ryan Hughes

Cape May

Cadence Golley Autumn Richards

Samantha Downes

Cumberland Larsen Del Collo

Gloucester

Jackie Monzo

Monmouth Rose Farra

Ocean

Kylene Stewart Estelle Balsirow Hunter Morgan

Maya Faulds Amanda Erbe

Morgan Przewoznik

1:30 pm Board Buses for afternoon activity

Load at side entrance

1:30-4:30 pm Afternoon Activity Community Service

5:00-6:00 pm Free Time and Prep for Banquet

6:15 pm County Rep Line-Up Outside Terrace Room

6:30-7:00 pm County Speeches Terrace Room

7:00-8:30 pm Banquet & Talent Show Terrace Room

9:00-11:00 pm Dance

Terrace Room

9:00-11:00 pm Games and Other Activities

Gallery

11:00 pm Quiet Time – Return to Room

Midnight Lights Out

Sunday, March 1, 2020 8:30-9:15 am Breakfast Terrace Room

9:15-9:30 am Morning Announcements

Terrace Room

9:30-11:00 am Closing Session *Inspiration *Summary *Evaluation

Terrace Room

11:00-11:30 am Check Out

8:45-12:15 pm

Workshop Sessions

Please Note: At the conference, workshops will be held in Plaza rooms 1 through 5. These will be scheduled as (3) 1-hour sessions based on the attendees registration selections. The Art of Zen

Your Voice and Words Express YOU!

Woven Together Bracelets

Collage It!

Paint Away Your Blues

Untangle Your Mind with Knitting

Dance Dance Dance

SJTC Jam

Painting with a Twist

4-H Talent Show

Wooden Sign Painting

Mindfulness, The Arts, and Confidence

Upcycled Art

Sew U Want 2 Sew

12:15 pm Last workshops session ends

12:30-1:30 pm Lunch & prepare for the afternoon activity

Gallery

Conference Meeting Rooms

GROUND LEVEL Hotel Lobby – Conference Registration

Gallery– Fri. Night Dinner Terrace Room- Sat. Banquet and Dance

Gallery – Sat. Breakfast and Lunch Game Room during Dance

MEZZANINE LEVEL Plaza 1-5 – Sat. Morning Workshops

What is the South Jersey 4-H Teen Conference? The South Jersey 4-H Teen Conference is an annual ten county conference for teens in grades 8-13 (one year out of high school) that focuses on leadership and personal development. Each year’s conference has specific goals related to the selected program theme. The program is designed by teen delegates on the 2020 SJTC Planning Committee in cooperation with 4‐H faculty and staff of Rutgers Cooperative Extension. This year’s theme is "Express Yourself with Music and the Arts" and focuses on self expression. Throughout the weekend, teens will:

- take part in experiential activities that reinforce self-confidence through creative thinking

- explore various music genres through singing, lyric analysis and song writing

- develop an understanding of visual arts while using a variety of materials

- learn from peer leaders as well as strengthen youth and adult partnerships through leading and participating in workshops

South Jersey 4-H Teen Conference is planned by South Jersey 4-H teens in cooperation with county 4-H faculty and staff of Rutgers Cooperative Extension. This event is open to teen in grades 8-13. 4-H Youth Development programs are offered to all youth, K-13 (one year out of high school), on an age-appropriate basis, without regard to race, religion, color, national origin, ancestry, age, sex, sexual orientation, gender identity and expression, disability, atypical hereditary cellular or blood trait, marital status, civil union status, domestic partnership status, military service, veteran status, and any other category protected by law. Rutgers Cooperative Extension encourages individuals with disabilities to participate in its programs and activities. All possible efforts will be made to include rather than exclude youth in events conducted by the 4-H Youth Development Program

South Jersey 4-H Teen Conference Schedule

Friday, February 28, 2020 5:00-7:30 pm Registration Hotel Lobby

5:30-7:00 pm Light Supper Gallery

6:45-7:30 pm Volunteer Chaperone Meeting

Plaza 5

7:30-8:00 pm Opening Session Gallery

8:00-10:00 pm Friday Evening Program Gallery

10:00-10:30 pm County Meetings Various locations

10:30-11:00 pm Quiet Time in Rooms

11:00 pm Lights Out

Saturday, February 29, 2020 7:00-7:30 am Morning Energizer Meet in lobby

7:15-8:15 am Breakfast Gallery

8:15 am Morning Announcements

Gallery

Name _______________________________________________________ County ________________________________

2020 SJTC WORKSHOP SELECTION FORM SESSION 1 – 8:45-9:45 am Ranking Workshop Description

Workshop Selections: Rank your 1st, 2nd, and 3rd choices for each session

____________ A. The Art of Zen: Zentangle is a form of art based on doodling that when put together, forms one large work of art. Come see how all of our creativity fits together! Presenter: Ellie Frank, Salem 4-H

____________ B. Your Voice and Words Express YOU! Learn how to express yourself with your singing voice,

and bring your inner thoughts to the page with lyric writing. Presenter: Cadence Golley, Cape May 4-H

____________ C. Dance Dance Dance: Have 2 left feet? Want to brush up on your dancing skills before Saturday

night? Attend this workshop and you will soon be Dancing with the 4-H Stars. Presenter: Chris-Tina Middlebrooks, Burlington

____________ D. Paint Away Your Blues: De-stress with painting without brushes, fun for all ages while

soothing background music plays. Presenters: Kylene Stewart, Morgan Przewoznik, Ocean 4-H ____________ E. SJTC Jam: Bring your musical instrument for a workshop jam. Prepare a musical presentation for

the talent show. Presenters: Spencer McKitrick and Brandon Rohn, Burlington County 4-H

SESSION 2 – 10:00-11:00 am Ranking Workshop Description

Workshop Selections: Rank your 1st, 2nd, and 3rd choices for each session

____________ A. Live Saturday Night: Showcase your talent in singing, spoken word or a musical instrument. This is a session to prepare for the Talent Show during the Saturday Banquet. Facilitator: Sharon Gore, Mercer 4-H

____________ B. Wooden Sign Painting: Design and create a custom wooden sign keepsake sign during this

hands-on workshop. Learn how to select wood pieces, stencil design and application as well as paint application techniques. No experience or painting skills needed. Presenter: Donna Griebau, Cumberland 4-H

____________ C. More Dance Dance Dance: Have 2 left Feet? Want to brush up your dancing skills before

Saturday night? Attend this workshop and you will soon be Dancing with the 4-H Stars. Presenter by Samy Figueroa, Burlington County, 4-H

____________ D. Collage It! Express who you are and your hopes and dreams on a vision board with these cut-

and-paste collages. Presenters: Estelle Balsirow and Maya Faulds, Ocean County 4-H. ____________ E. Untangle Your Mind with Knitting: Knitting is a unique skill: it's relaxing but also results in

practical creations like hats, bags and scarves. Learn how to relax fast as you try simple stitches, then take this fun hobby with you anywhere! Presenters: Dasani Platt, Mercer 4-H and Annette Devitt, 4-H Alumni

SESSION 3 – 11:15-12:15 pm Ranking Workshop Description

Workshop Selections: Rank your 1st, 2nd, and 3rd choices for each session

____________ A. Mindfulness, The Arts, and Confidence: Center yourself with breathing techniques and learn the confidence to create. Presenter: Laura Eppinger, Salem County 4-H

____________ B. Sew U Want 2 Sew: This is a make-and-take workshop allowing participants to learn how to

operate a sewing machine and make a drawstring tote bag to fill with SJTC memories. Presented by Program Associates, Sharon Gore, Mercer 4-H and Karen Mansue, Ocean 4-H.

____________ C. Upcycled Art: Are you a friend of the environment? Do you like to reuse materials otherwise

destined for a landfill? Come join the fun and be creative using wallpaper and fabric to create a seasonal three-dimensional project. Presented by Altaira Bejgrowicz, Program Associate, Mercer County

____________ D. Painting with a Twist: Come to learn different styles of painting, gain the confidence to express

yourself through different painted media, and take home a painted canvas. Presenter: Brianna Boyd, Program Assistant and Shianne Figueroa 4-H Member, Burlington County:

____________ E. Woven Together Bracelets: Learn how to make these simple woven bracelets to wear yourself

or share with a friend. Presenters: Grace Cloos and Cheyenna Lowe, Ocean 4- H Members

SOUTH JERSEY 4-H TEEN CONFERENCE REGISTRATION FORM

County Registration Deadline: __(county staff adds date here)_____________ Code: _________(for office use only)

Teens: Complete Sections I, II, III of this Registration Form and return by the deadline to your county 4-H office

with a check. You may choose a double room with 2 beds and 2 roommates (cost $250.00 per person) or a quad room with 2 beds and 4 roommates (cost $195.00 per person). Please make checks payable to your county 4-H account, as instructed by your 4-H agent.

REFUND POLICY Once you register for South Jersey Teen Conference, you are responsible for the cost of the conference and are expected to attend from Friday evening to Sunday morning.

Section I. YOUTH/ADULT PARTICIPANT INFORMATION Name_________________________________________Birthdate_____________Age________

Street Address _______________________________________________ Grade __________

City & State__________________________ Zip ____________ Phone _______________

4-H County _________________________ Gender ___________

E-mail Address ______________________________________________________________

Banquet Entree Choice (circle one) Chicken ______ or Pasta (vegetarian option)______ Please indicate any special needs (food or accommodations) you may have______________________________

Adults: Complete Sections I and IV only. Return by the deadline to your county 4-H office.

Section II. YOUTH PARTICIPANT ROOMMATE PREFERENCE Please list the name of ONE roommate choice below. Before completing this section, check with roommate choice to avoid confusion. County 4-H staff will assign rooms of two ($250.00) or four ($195.00). There will be no switching of rooms at the conference. Your roommate choice must also request you on their registration form Name of Roommate Preference ___________________________________ County: _______________________________

Section IV. ADULT ADVISOR'S REGISTRATION

Advisors should complete Section I and Section IV (check with your 4-H agent regarding payment of registration fee and roommate selection). Advisors must complete the 4-H Event Release/Agreement Form for Adults, signing in all places. Roommate ______________________________________________________________________

Section III. ITEMS REQUIRED TO BE INCLUDED WITH REGISTRATION FORM FOR YOUTH PARTICIPANTS

Enclosed with this registration form are the following items: _____ A check or money order made payable to ____________________ for the full conference fee $195.00 if 4 in a room, $250.00 if 2 in a room _____ A completed copy of the 4-H Event Permission Form for Youth, signed by my parent/guardian and myself. _____ Workshop Selection Form _____ Saturday Afternoon activity selection form

SATURDAY AFTERNOON ACTIVITIES Name _________________________________________________________ County ____________________

PLEASE INDICATE YOUR 1st and 2nd CHOICE: ____ The Salvation Army KROC CENTER in Camden The Kroc Center is an unprecedented place of gathering and enrichment which houses an array of educational, sports, faith, art, and supportive programs that are accessible to all. The 120,000 square foot facility is located on 24 acres and is designed to stimulate the mind, body and spirit, to provide hope, and to transform the lives of community members. For a better look…you can check it out at camdenkroccenter.org The 4-H visit will include two components. First – Counties will work as a team to assemble their “ARTS Activity Kit”. These children’s programs in a tote are designed for future use by the Kroc Center staff. Once the kits are completed, our group will have the use of the COMPETITION POOL and the WATER PARK. The pool has eight lanes that are four to seven feet deep and twenty four yards long. The water park features a two-story water slide, beach-entry pool, lazy river, recreation splash space, and warm water pool.

____ Two Community Service SEWING PROJECTS – At the hotel This year’s SJTC community service sewing projects will help two important causes. No previous hand or machine sewing skills required. Learn to sew or sharpen your skills!

Ryan’s Case for Smiles is dedicated to helping sick children cope with life-changing illnesses. This organization encourages people to make pillowcases so children can feel better to heal better. You will be sewing cheerful pillowcase to brighten up hospital rooms for young patients and put a smile on their face. In addition, we will be sewing fleece hats for needy children in the city of Camden who attend the Kroc Center’s afterschool programs.

SJTC will continue to “Make the Best Better” by helping those in need.

&

Help others to get creative and express themselves by donating music, arts, and craft supplies. All donations will go to the Kroc Center for the needy.

Need some ideas: Paint, canvas, brushes, drawing/watercolor paper, markers, crayons, colored pencils, glue, fabric, scissors, pipe cleaners, pompoms, glitter, toy or real musical instruments, scrapbooking supplies, yarn, ribbon, tape, sponges, paper towels, paper plates, chalk, rulers…

Drop off your donations in the marked bin located in the Crowne Plaza lobby when you arrive at SJTC.

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2020 South Jersey Teen Conference Talent Show Registration Form

Name___________________________________________County_________________

Names of other participants (if any)

Name___________________________________________County_________________

Name___________________________________________County_________________

Name___________________________________________County_________________

Talent (check one) Performance____________ Exhibit__________________

You are responsible for your own music and equipment

Make sure you select “Live Saturday Night” for your workshop

selection

New Jersey 4-H Event

Permission Form for Youth

4H104

Both sides of this form must be completed by all youth participating in overnight activities, field trips, events requiring group

transportation, and any other events sponsored through the 4-H Youth Development Program where it is deemed necessary by the

event coordinator(s) (paid 4-H staff and/or registered 4-H volunteer) responsible for the youth participants. The form should be

submitted prior to the event. The form has five parts: (1) information about the participant and activity, (2) parental permission and

liability release, (3) medical emergency authorization and health information, and (4) code of conduct and (5) media policy. Be sure to

complete all five parts and sign where requested!

Information about the Youth Participant and Activity

Name of Youth participant: ____________________________________________________________________________________

Address: _______________________________________________ City:__________________ State:_______ Zip:__________

Telephone number: (____) _________________________________ Email Address: ___________________________________

4-H county: ____________________________________________ Birthdate: ____________________ Grade: _______________

Name of activity/event: ____South Jersey 4-H Teen Conference______________________________________________________

Name of 4-H group sponsoring or participating in this event: --Rutgers Cooperative Extension- 4-H Youth Development___________

Location of event: ___Crowne Plaza Hotel, Cherry Hill, NJ______2349 Marlton Pike West, ________________________________

Date and time of participation of individual named above: _February 28, 2020, 3:00 PM to Sunday, March 1, 2020 11:00 AM___

Parent Permission and Release of Liability

I hereby give my son/daughter named above permission to participate in the event listed. Although Rutgers Cooperative Extension and

its event coordinator(s) will use the utmost precaution in guarding the health of the above participant and preventing accidents, I

release them from any liability in case of illness or injury as a result of this activity. Furthermore, I release the owner and driver of the

car transporting my child to and from the event, from any liability in case of illness or injury.

Signature of parent or guardian: _________________________________________________________________

Medical Emergency Authorization and Health Information

I authorize the event coordinator(s) to dispense the prescription drugs and/or over the counter medications listed below in accordance

with the instructions provided on the label (prescription drugs) or below (over-the-counter medications). In case of sudden illness or

an accident to the above named participant requiring immediate treatment or surgery while he/she is a participant in this activity, I

authorize the 4-H chaperone(s) to take such action as seems appropriate to protect the health and physical well-being of the above

participant. This authority extends to any physician(s) and/or surgeon(s) selected by the event coordinator(s) to perform medical

and/or surgical procedures including examinations and tests necessary to preserve the health and physical well-being of the above

named participant. All efforts will be made to contact the parent(s) or guardian(s) in case of emergency.

________________________________________________ ____________________________________________________

Name of parent/guardian Phone number Name of additional emergency contact Phone number

The following information is provided as an aid to the event coordinator(s) in dealing with the well-being of the participant. The

participant has the following health conditions: (include allergies, handicaps, diabetes, pregnancy, asthma, medications needed, etc.).

Health conditions: ___________________________________________________________________________________________

Medications/Instructions: _____________________________________________________________________________________

Health Insurance: Company Group# ___________________________________ ID# _____________________________________

Signature of parent or guardian ________________________________________________________________

Sign Here

Sign Here

Continued on other side

New Jersey 4-H Code of Conduct

The primary purpose of the New Jersey 4-H Code of Conduct is to ensure the safety and well-being of all

participants at 4-H sponsored events and activities. It applies to all participants, with participants defined as 4-H

members, their parents, and volunteers.

As a participant in the 4-H program, I will:

Conduct myself in a courteous manner and treat members, parents, 4-H volunteers, Extension staff, judges and

others with respect. Appropriate language and behavior are expected at all times.

Respect and adhere to the rules and guidelines of the 4-H program including all those specific to a 4-H event or

activity.

Uphold an individual’s right to dignity by supporting an environment of inclusion which welcomes involvement

of participants from all backgrounds.

Accept supervision and support from county and state 4-H staff while participating in the 4-H program. This

includes acceptance of supervision and support from appointed 4-H volunteers coordinating 4-H events and

activities.

Obey local, state and federal laws.

Participants who fail to adhere to the New Jersey 4-H Code of Conduct are subject to a range of disciplinary

actions. Such actions will be taken in compliance with the New Jersey 4-H Discipline Policy and Procedure.

When appropriate, immediate corrective action will be taken at the 4-H event to ensure the safety and welfare of

all participants.

I understand if I fail to adhere to the above Code of Conduct, I will be subject to disciplinary action and potentially prohibited from attending and participating in the New Jersey 4-H Youth Development program.

_______________________________________________________ ____________________________________

Signature of participant in event Date

_______________________________________________________ ____________________________________

Signature of parent or guardian Date

New Jersey 4-H Media Policy and Release

The 4-H program routinely promotes activities through various media. This includes, but is not limited to newsletters, newspapers,

brochures, and displays. In doing so, the names and photos of members may be included to help tell the 4-H story. However, New

Jersey 4-H policy is that on web sites, youth in photos will not be identified by name(s).

❑ No, do not use my individual picture for any purpose. I will make an effort to avoid opportunities to be in group photos.

❑ No, do not use my name for any purpose.

Revised: January 2013

Sign Here

Sign Here

New Jersey 4-H Release/ Agreement Form for Adults

4H103

Both sides of this form must be completed and signed by all adults participating in 4-H overnight activities, field trips, and events

requiring group transportation where youth are present, or any other events sponsored through the 4-H Youth Development Program

as determined by the event coordinator. The form should be submitted prior to the event.

Information about the Adult Participant and Activity

Name of Adult participant: ____________________________________________________________________________________

Address: _______________________________________________ City:__________________ State:_______Zip:___________

Telephone number: (____) _________________________________ Email Address: ___________________________________

4-H county: _______________________________ Have you gone through the appointed volunteer process? Yes No

Name of activity/event: ____South Jersey 4-H Teen Conference______________________________________________________

Name of 4-H group sponsoring or participating in this event: --Rutgers Cooperative Extension- 4-H Youth Development___________

Location of event: ___Crowne Plaza Hotel, Cherry Hill, NJ______2349 Marlton Pike West, ________________________________

Date and time of participation of individual named above: _February 28, 2020, 3:00 PM to Sunday, March 1, 2020 11:00 AM___

Release of Liability Although Rutgers Cooperative Extension and its event coordinator(s) will use the utmost precaution in guarding the health of all

participants and preventing accidents, I release them from any liability in case of injury as a result of this activity. Furthermore, I

release the owner and driver of the car transporting me to and from this event, from any liability in the case of illness or injury.

Signature of adult participant ___________________________________________________________________

Medical Emergency Authorization and Health Information In case of sudden illness or an accident to myself requiring immediate treatment or surgery while I am a participant in this activity, I

authorize the 4-H event coordinator or other adults present to take such action as seems appropriate to protect my health and physical

well-being. This authority extends to any physician(s) and/or surgeon(s) selected to perform medical and/or surgical procedures

including examinations and tests necessary to preserve my life and well-being. All efforts will be made to contact the individual

named as my emergency contact above in case of emergency.

________________________________________________ ____________________________________________________

Name of emergency contact Phone number Name of additional emergency contact Phone number

The following information is provided as an aid to the event coordinator in dealing with my well-being. I have the following

conditions (include allergies, handicaps, diabetes, pregnancy, asthma, medications needed, etc.):

Health conditions: ___________________________________________________________________________________________

Medications/Instructions: _____________________________________________________________________________________

Health Insurance: Company Group# ___________________________________ ID# ______________________________________

Signature of adult participant ___________________________________________________________________

Continued on other side

Sign Here

Sign Here

New Jersey 4-H Code of Conduct

The primary purpose of the New Jersey 4-H Code of Conduct is to ensure the safety and well-being of all

participants at 4-H sponsored events and activities. It applies to all participants, with participants defined as 4-H

members, their parents, and volunteers.

As a participant in the 4-H program, I will:

Conduct myself in a courteous manner and treat members, parents, 4-H volunteers, Extension staff, judges and

others with respect. Appropriate language and behavior are expected at all times.

Respect and adhere to the rules and guidelines of the 4-H program including all those specific to a 4-H event or

activity.

Uphold an individual’s right to dignity by supporting an environment of inclusion which welcomes involvement

of participants from all backgrounds.

Accept supervision and support from county and state 4-H staff while participating in the 4-H program. This

includes acceptance of supervision and support from appointed 4-H volunteers coordinating 4-H events and

activities.

Obey local, state and federal laws.

Participants who fail to adhere to the New Jersey 4-H Code of Conduct are subject to a range of disciplinary

actions. Such actions will be taken in compliance with the New Jersey 4-H Discipline Policy and Procedure.

When appropriate, immediate corrective action will be taken at the 4-H event to ensure the safety and welfare of

all participants.

I understand if I fail to adhere to the above Code of Conduct, I will be subject to disciplinary action and

potentially prohibited from attending and participating in the New Jersey 4-H Youth Development program.

________________________________________________ ____________________________________

Signature of participant Date

New Jersey 4-H Media Policy and Release The 4-H program routinely promotes activities through various media. This includes, but is not limited to newsletters, newspapers,

brochures, and displays. In doing so, the names and photos of members may be included to help tell the 4-H story. However, New

Jersey 4-H policy is that on web sites, youth in photos will not be identified by name(s).

❑ No, do not use my individual picture for any purpose. I will make an effort to avoid opportunities to be in group photos.

❑ No, do not use my name for any purpose.

Revised: January 2013

Sign Here

2020 SJTC 4-H Shirt Order Form

Due to Burlington County by February 1, 2020

Name _________________________________________________County____________________________________

Long Sleeve T-Shirts cost $14.00 each.

Hooded Sweatshirts cost $25.00 each

Orders must be placed and prepaid by February 1, 2019.

Checks made payable to Burlington County 4-H Teen Council.

(Sizes larger than Adult XL are available by special order at an additional cost.)

Long Sleeve T-Shirt size Adult S, M, L, XL #________ at $14.00 = $________ XXL, XXL #________at $16.00

Hooded Sweatshirt Size Adult S, M, L, XL #________ at $25.00 = $________ XXL, XXL #________at $27.00

Check #___________________ Total Amount $________________

Return mail your order form and check to Burlington County 4-H Office:

RCE of Burlington County, 4-H Office, PO Box 6000, Mt Holly NJ 08060

Any questions? Contact Nancy Horrisberger at the Burlington County 4-H Office at 609-265-5052