FARM & TRACTOR SAFETY COURSE National Safe
FARM & TRACTOR SAFETY COURSE National Safe tractor & Machinery operation Program SPONSORED BY REARDON BRIGGS CO. INC.
REGISTRATION Please fill out the attached registration form and mail it with your check (made payable to CCEDC) to: Cornell Cooperative Extension Dutchess County Attn: Cassie 2715 Route 44 Millbrook, NY 12545 Registrations are limited, spaces will be filled on a first come first served basis. Incomplete registrations or registrations without payment will not be accepted. You will be notified when we receive your registration.
Dutchess County 4-H will be hosting a National Safe Tractor and Machinery Operation Program (NSTMOP) course this Spring! Youth ages 14 and up will receive a training certificate; allowing them to hold jobs on farms and legally allow them to use farm equipment. Youth ages 8-13 are welcome to participate in the classroom portion of the training (with help from a parent where needed) however they are ineligible for certification. ALL PARTICIPANTS MUST BE ENROLLED IN 4-H .
The cost of the course is $35.00 for the student manual and materials.
No registrations will be accepted after February 11th. Questions, please call Cassie Messina at (845)677-8223 x.108 or email at [email protected] www.reardonbriggs.com Cornell Cooperative Extension provides equal program and employment opportunities. The County of Dutchess partially funds Cooperative Extension Programming in Dutchess County.
NATIONAL SAFE TRACTOR & MACHINERY OPERATION PROGRAM
CLASS SCHEDULE Day #
Date
Time
Location
Class Content
1
February 25th Thursday
6:308:30pm
Farm & Home Center Millbrook, NY
Registration - Parent/Guardian Signature Required Introduction to Cornell Cooperative Extension and 4-H Club Programs Introduction to NSTMOP Program
2
March 3rd Thursday
6:308:30pm
Farm & Home Center Millbrook, NY
Tractor Controls Tractor Operation
3
March 10th Thursday
6:308:30pm
Farm & Home Center Millbrook, NY
Tractor Safety on the Road Starting and Stopping Tractors
4
March 12th Saturday
9am-11am
Farm & Home Center Millbrook, NY
Special Guest Speaker
5
March 17th Thursday
6:308:30pm
Farm & Home Center Millbrook, NY
Tractor Hitches, PTO’s and Hydraulics
6
March 19th Saturday
9am12noon
Farm & Home Center Millbrook, NY
7
March 31st Thursday
6:308:30pm
Farm & Home Center Millbrook, NY
Review/Catch-up Book Check Practice Test
8
April 2nd Saturday
8:30 am12noon
Farm & Home Center Millbrook, NY
TESTS Written, Driving and Daily Maintenance
—
April 9th Saturday
9am
Farm & Home Center Millbrook, NY
TEST RAIN DATE
Driving Practice Session SPONSORED BY REARDON BRIGGS
** Please note, participants must attend 4 out of 5 Thursday sessions, 3/12 AND 4/2. Cornell Cooperative Extension provides equal program and employment opportunities. The County of Dutchess partially funds Cooperative Extension Programming in Dutchess County.
CHILD’S NAME: _________________________________________________________________ AGE: _____
ADDRESS: _______________________________________________________________________________
SIGNATURE: _____________________________________________________________ DATE: __________
PARENT/GUARDIAN’S NAME (print): __________________________________________________________
The above agreement shall be binding on my heirs, successors, assigns, administrators, and executors. Any claims or disputes arising out of my child’s participation in this activity shall be venued in the Supreme Court of the State of New York located in the county of the Extension office.
I HAVE READ THE ABOVE AND BY SIGNING BELOW, I AGREE IT IS MY INTENTION TO GRANT PERMISSION FOR MY CHILD TO PARTICIPATE IN THE INDICATED ACTIVITY.
My child is in good health. I understand that he/she will participate in strenuous physical activity.
I fully understand and acknowledge that there are inherent risks and dangers in my child’s participation in the above activities and my child’s participation in such activities and use of any equipment related to such activities may result in injury, illness, or death, and damage to personal property. I understand other participants, accidents, forces of nature, or other incidents may cause these risks and dangers and I hereby accept these risks and dangers.
I hereby grant permission for my child ________________________________________ to participate in the National Safe Tractor and Machinery Operation Program Activity sponsored by Cornell Cooperative Extension of Dutchess County on the dates of February 25, 2016 through April 2, 2016 and acknowledge as follows:
This form must be completed before child may participate.
CORNELL COOPERATIVE EXTENSION DUTCHESS COUNTY, NEW YORK Acknowledgement of Risk
4-H Club: _____________________________________________________________________
Phone #: ____________________ Email: ___________________________________________
Address: _____________________________________________________________________
Name: _____________________________________________________________ Age: _____
REGISTRATION FORM
NATIONAL SAFE TRACTOR & MACHINERY OPERATION PROGRAM (NSTMOP)
REGISTRATION Please fill out the attached registration form and mail it with your check (made payable to CCEDC) to: Cornell Cooperative Extension Dutchess County Attn: Cassie 2715 Route 44 Millbrook, NY 12545 Registrations are limited, spaces will be filled on a first come first served basis. Incomplete registrations or registrations without payment will not be accepted. You will be notified when we receive your registration.
Dutchess County 4-H will be hosting a National Safe Tractor and Machinery Operation Program (NSTMOP) course this Spring! Youth ages 14 and up will receive a training certificate; allowing them to hold jobs on farms and legally allow them to use farm equipment. Youth ages 8-13 are welcome to participate in the classroom portion of the training (with help from a parent where needed) however they are ineligible for certification. ALL PARTICIPANTS MUST BE ENROLLED IN 4-H .
The cost of the course is $35.00 for the student manual and materials.
No registrations will be accepted after February 11th. Questions, please call Cassie Messina at (845)677-8223 x.108 or email at [email protected] www.reardonbriggs.com Cornell Cooperative Extension provides equal program and employment opportunities. The County of Dutchess partially funds Cooperative Extension Programming in Dutchess County.
NATIONAL SAFE TRACTOR & MACHINERY OPERATION PROGRAM
CLASS SCHEDULE Day #
Date
Time
Location
Class Content
1
February 25th Thursday
6:308:30pm
Farm & Home Center Millbrook, NY
Registration - Parent/Guardian Signature Required Introduction to Cornell Cooperative Extension and 4-H Club Programs Introduction to NSTMOP Program
2
March 3rd Thursday
6:308:30pm
Farm & Home Center Millbrook, NY
Tractor Controls Tractor Operation
3
March 10th Thursday
6:308:30pm
Farm & Home Center Millbrook, NY
Tractor Safety on the Road Starting and Stopping Tractors
4
March 12th Saturday
9am-11am
Farm & Home Center Millbrook, NY
Special Guest Speaker
5
March 17th Thursday
6:308:30pm
Farm & Home Center Millbrook, NY
Tractor Hitches, PTO’s and Hydraulics
6
March 19th Saturday
9am12noon
Farm & Home Center Millbrook, NY
7
March 31st Thursday
6:308:30pm
Farm & Home Center Millbrook, NY
Review/Catch-up Book Check Practice Test
8
April 2nd Saturday
8:30 am12noon
Farm & Home Center Millbrook, NY
TESTS Written, Driving and Daily Maintenance
—
April 9th Saturday
9am
Farm & Home Center Millbrook, NY
TEST RAIN DATE
Driving Practice Session SPONSORED BY REARDON BRIGGS
** Please note, participants must attend 4 out of 5 Thursday sessions, 3/12 AND 4/2. Cornell Cooperative Extension provides equal program and employment opportunities. The County of Dutchess partially funds Cooperative Extension Programming in Dutchess County.
CHILD’S NAME: _________________________________________________________________ AGE: _____
ADDRESS: _______________________________________________________________________________
SIGNATURE: _____________________________________________________________ DATE: __________
PARENT/GUARDIAN’S NAME (print): __________________________________________________________
The above agreement shall be binding on my heirs, successors, assigns, administrators, and executors. Any claims or disputes arising out of my child’s participation in this activity shall be venued in the Supreme Court of the State of New York located in the county of the Extension office.
I HAVE READ THE ABOVE AND BY SIGNING BELOW, I AGREE IT IS MY INTENTION TO GRANT PERMISSION FOR MY CHILD TO PARTICIPATE IN THE INDICATED ACTIVITY.
My child is in good health. I understand that he/she will participate in strenuous physical activity.
I fully understand and acknowledge that there are inherent risks and dangers in my child’s participation in the above activities and my child’s participation in such activities and use of any equipment related to such activities may result in injury, illness, or death, and damage to personal property. I understand other participants, accidents, forces of nature, or other incidents may cause these risks and dangers and I hereby accept these risks and dangers.
I hereby grant permission for my child ________________________________________ to participate in the National Safe Tractor and Machinery Operation Program Activity sponsored by Cornell Cooperative Extension of Dutchess County on the dates of February 25, 2016 through April 2, 2016 and acknowledge as follows:
This form must be completed before child may participate.
CORNELL COOPERATIVE EXTENSION DUTCHESS COUNTY, NEW YORK Acknowledgement of Risk
4-H Club: _____________________________________________________________________
Phone #: ____________________ Email: ___________________________________________
Address: _____________________________________________________________________
Name: _____________________________________________________________ Age: _____
REGISTRATION FORM
NATIONAL SAFE TRACTOR & MACHINERY OPERATION PROGRAM (NSTMOP)
