HEALTH & WELLNESS 

 - 4-H BICYCLE RECORD
Year _________

Name  	

Age  	

Years in Project  	

List Goals:	

List on a separate line each thing you plan to learn, make or do.	I will need help	I will do myself	I did great	I
did ok	Not so good	Plan to do next year	

							

							

Basic Skills Learned:
Date	Skill	Where Learned	How Learned

 	 	 	

 	 	 	

Bike Maintenance and Repair:
Date	Skill	Where Learned	How Learned

 	 	 	

 	 	 	

List project meetings, workshops, field trips, camps, exhibition, etc., attended. Give place & date.
Event	Place	Date

 	 	

 	 	

List presentations given about this project. Include title, date and place.
Type of presentation	Title of presentation	Place	Date

 	 	 	

List bicycle leadership you provided during the year. List what you did, when and with whom. Leadership	Date	Who

 	 	

 	 	

List bicycle citizenship you provided during the year. List what you did, when and with whom. Citizenship	Date	Who

 	 	

 	 	

Rides, rodeos/clinics participated in. List name of event, place and date. Event	Date	Place

 	 	

 	 	

Exhibits shown or races. List number of exhibits, place raced and awards received. Number	Type	Place	Awards

 	 	 	

 	 	 	

 	 	 	

4-H Bicycle STORY & PHOTOS
Attach a separate sheet of paper with a story telling why you chose this project, talk about experiences, challenges, successes, activities, etc... May also include up to three (3) pages of photos.

______________________________	________________________ 4-H member signature		Project Leader signature

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