K12 Glaze Calc & Chemistry with Matthew Dercole Registration

Name*

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Mailing Address*

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Email*

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Personal Email

Incase you move institutions, please tell us your personal email so we can still reach you with arts opportunities.

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School Name*

Watershed's K12 workshops are reserved for current Maine K12 teachers. Please list the name of the Maine-based school or institution where you currently teach.

Number of Students & Grades*

Please describe the number of students and what grades you teach.

Cost Reimbursment*

For grant purposes, do you anticipate this expense being reimbursed by your employer?

Workshop Registration*

K12 Workshop Registration, $75

Using Credit Balance

Housing

Thanks to the generous support of the Onion and Anonimo Foundations, Watershed is able to offer a limited number of single and double occupancy rooms free of charge, which will be filled on a first-come, first-served basis. Rooms have shared bath facilities. If staying on campus, please bring your own bedding and bath towel.

Single occupancy room, 2 nights (Wed, Thurs)

Single occupancy room, 1 night (Thurs)

Double occupancy room, 2 nights (Wed, Thurs)

Double occupancy room, 1 night (Thurs)

Stay Off Campus

Dietary Needs*

Watershed will provide lunch for all workshop participants. Please indicate below if you require a vegetarian and/or gluten free option. Those with additional dietary needs may bring supplemental food, which can be stored in the Watershed studio kitchen.

I don't have any dietary needs or restrictions.

Vegetarian

Vegan

Gluten Free

Other, I will explain in "Additional Info" below

Additional Information

If you wish, please use the space below to share any information pertaining to your wellbeing that Watershed staff should be aware of prior to the workshop. This could include dietary information, accessibility needs, etc.

Permissions

Photo Release*

I agree to grant Watershed Center for the Ceramic Arts and its authorized representatives permission to record my likeness and images of my work during the time that I am in residence. I further agree that any or all of the recorded material may be used, in any form, as part of publications, videos, brochures, advertisements or other digital or printed materials used to promote Watershed. I acknowledge that since the use of my likeness and my work is voluntary, I will receive no financial compensation.

Agree

Decline

Email Address Release*

I grant Watershed Center for the Ceramic Arts permission to share my e-mail address with the teaching artist and other participants of the workshop.

Agree

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Liability Waiver*

Please read Watershed's Liability Waiver and check the box below to indicate your voluntary agreement. If you have any questions regarding the Liability Waiver, you may email Watershed's Executive Director at director@watershedceramics.org.

By checking this box, I indicate that I have read the entire Liability Waiver, I fully understand it, I am agreeing to it voluntarily and I agree to be legally bound by it.

COVID Health & Safety Guidelines*

Watershed requires on-campus program participants to follow our COVID health and safety guidelines in order to care for the most vulnerable in our community. Please familiarize yourself with these before submitting your non-refundable deposit. Watershed reserves the right to adjust the guidelines, as needed. Read the guidelines here.

I have read and agree to follow Watershed's COVID Health & Safety Guidelines

Cancellation Policy*

Please read Watershed's Cancellation Policy and check the box below to indicate your voluntary agreement. If you have any questions regarding cancellations, please email Watershed's Program Coordinator at afraser@watershedceramics.org.

I have read and agree to Watershed's Program Cancellation Policy

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