Summer Residency Student Assistantship Registration If you are a student who has been chosen by their school to attend a summer residency session, please fill in your information below. "*" indicates required fields Name* First Last Mailing Address* Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Phone*Email* Enter Email Confirm Email Funding Institution*School NameTell Us About YourselfWe ask these questions to provide you with appropriate meals and to help us better pair roommates and suitemates, who will share common areas and bathroom facilities.Birthdate* MM slash DD slash YYYY Gender* Female Male Nonbinary Please indicate any gender preference(s) for a roommate.**Check all that apply. Female Male Nonbinary Dietary Restrictions*Check all that apply. Watershed serves a vegetarian option with every meal and makes accommodations for gluten free and dairy free participants. If you have additional dietary restrictions, please explain your needs in Additional Information section. Staff will follow up with you to determine if your dietary needs can be met. I don't have any dietary restrictions Gluten Free Dairy Free Vegetarian Other, I will explain in "Additional Info" below Additional InformationIf you wish, please use the space below to share any information pertaining to your wellbeing that Watershed staff should be aware of prior to your residency. This can include dietary information, accessibility needs, etc. First Choice Residency Session*I: May 22 - Jun 2, Clay In The Expanded FieldII: Jun 5 - 16, Socially Engaged MakingIII: Jun 19 - 30, Transitions: Embracing ChangeIV: Jul 3 - 14, Embodied PerceptionV: Jul 24 - Aug 4, Research & PracticeVI: Aug 21 - Sep 1, Functionally YoursSecond Choice Residency Session*I: May 22 - Jun 2, Clay In The Expanded FieldII: Jun 5 - 16, Socially Engaged MakingIII: Jun 19 - 30, Transitions: Embracing ChangeIV: Jul 3 - 14, Embodied PerceptionV: Jul 24 - Aug 4, Research & PracticeVI: Aug 21 - Sep 1, Functionally YoursAgreement.*Watershed assistants perform a variety of work during their residency, from washing dishes and cleaning up after meals to helping in the studios and performing grounds maintenance. I understand that as an assistant, I agree to work for Watershed for 3 hours each week day that I am in residence. 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 E-mail Address Release*I grant Watershed Center for the Ceramic Arts permission to share my e-mail address with all other members of my residency group, in order to facilitate conversations around communal goals, kiln firings, travel, etc. Agree Decline COVID-19*Watershed's 2021 and 2022 summer residencies were guided by a number of successful Covid-19 pandemic safety guidelines, in order to care for the most vulnerable in our community. We cannot predict what health and safety measures will be in place for summer 2023 and Watershed reserves the right to adjust guidelines and protocols. We ask that you read and familiarize yourself with our most recent health and safety guidelines before putting down your non-refundable deposit. Read the Guidelines here. I have read and agree to Watershed's anticipated COVID-19 guidelines. 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. Δ