Name: A Wild “Pottery Party”: Saturday, January 13th (click here to enroll) — The Wild Way
Start: 2024-01-13T10:00:00-0500
End: 2024-01-13T12:00:00-0500
Location: Common Clay Collective

Saturday, January 13, 2024
10:00 AM 12:00 PM

Common Clay Collective 1111 Shenandoah Avenue Northwest Roanoke, VA, 24017 United States (map)

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Feeling crafty this winter? We’re having a Pottery Party!

Note: This event is now full, but you can still sign up to join our waiting list.

The Wild Way is partnering with Common Clay Collective to hold a Pottery Party on Saturday, January 13th from 10am to 12pm. Join us to learn about pottery and create your own outdoor-themed clay masterpiece.

Please note that transportation for this event will NOT be provided. You will be responsible for dropping off and picking up your child. More details on drop-off and pick-up will be provided in a follow-up email. (If your child would like to join us but transportation is a barrier to her participation, please email us at info@thewildway.org so we can try to find a solution.)

Participant Name *

First Name

Last Name

Participant Date of Birth *

YYYY

Her School and Current Grade *

What is your relation to the child? *

Parent/Guardian

Other

If "Other" please explain

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Email *

Have you ever participated in The Wild Way in the past? If so, which course? *

Why would your child like to participate in this course? *

Do you know anyone else enrolled in or applying to participate in this course? If so, who?

What is your race/ethnicity? *

African American or Black

American Indian or Alaska Native

Asian American

Latinx

Middle Eastern or North African

Native Hawaiian or Other Pacific Islander

White/Caucasian

Multi-racial

Other race, ethnicity, or origin

Primary household language *

Please disclose any medical conditions that may impact your child's safety or ability to participate. (Write "None" if none apply.) *

Will your child require any medication to be administered during her participation in the program? If so, please describe the medication, dosage, and administration. (Write "None" if none apply.) *

Does your child have any environmental and/or food allergies? Please describe the allergies, their severity, and your child's reaction. (Write "None" if none apply.) *

Does your child require a special diet or have any food intolerances? (Write "None" if none apply.) *

Money should never be a barrier to enjoying the outdoors. The Wild Way provides services on a sliding scale fee. We ask that families who are financially-able make a contribution for their child to participate. *

The full cost of this activity is $40 per child, but The Wild Way gladly provides fee reductions and fee waivers. Please indicate the amount that you'd be able to contribute. Our services are FREE for families in need! Please don't hesitate to request a fee waiver if needed. After you submit this form, you will be directed to a Payment page. If you are requesting a fee waiver, please IGNORE that page and close the browser window.

$40

$20

Request a fee waiver

How did you find out about The Wild Way? *

Online search (Google, Yahoo, etc.)

Facebook

Instagram

E-mail marketing

School/community events (e.g. GO Fest)

Referral

Word of mouth

Thank you!