Clinton Art Association River Arts Center
& Rainbow Pottery Present…..
Practial Pottery-A Hands On Experience
4-H Club for Grades 4-12
What is this club all about?
Rainbow Pottery in Clinton, IA has partnered with the Iowa State University Extension and Outreach organization to
provide The Practical Pottery Club! Club activities will involve developing hand and artistic skills through decorating
ceramics, constructing clay objects and practical uses of clay.
Where and When?
The Pottery Club will meet at Rainbow Pottery in Clinton the following dates during the 2014/2015 school year: 10/8,
10/22, 11/15, 12/10, 01/14, 02/11, 03/11, 04/01, 04/29, & 05/13(final work on projects and pick up day). All meeting
will be held on Wednesday afternoons from 3:00-5:00pm, with the acceptation of one Saturday meeting in November.
This will be a total of 10 sessions. Commitment to most of these sessions is needed with enrollment. Projects may roll
over from session to session.
Cost?
The cost of this club will be $30.00 per year. Registered 4-H members to not have to pay any additional registration
fees. If you will be paying for this club please send a check along with your registration. You may also pay with cash at
the Extension Office. There will be an additional materials fee of $45.00. The materials fee will cover the cost of all
materials used for programs. Financial assistance is available upon request!! To fill out a request please visit:
http://www.extension.iastate.edu/clinton/4h to download the form.
Registration Deadline
Please return registrations forms to the Extension Office no later than Monday, October 6th. This club is limited to 15
participants!!! Please contact Kelli with any questions kmjahn@iastate.edu or 563-570-3120
Please mail this form to:
Kelli Jahn
c/o Pottery Club Registration
Clinton County Extension
400 E 11th Street
DeWitt, IA 52730
Practical Pottery Registration Form
Youth Name:___________________________________________________________________________________
Parent/Guardian Name: _______________________________________________________________________
Address: _______________________________________________________________________________________
City, Zip:_______________________________________________________________________________________
Home Phone:_______________________________ Cell Phone:_____________________________________
Email: __________________________________________________________________________________________
Male_______ Female_______
Birth date: _______________________________________
T-Shirt Size: YS
AS AM
YM YL
AL
School: __________________________________________
Grade: __________________________________
Photography Release Consent:
_____Yes, pictures of my child may be used for publicity purposes, news articles, and the Extension Web Page.
_____No, do not use pictures of my child.
Release Information:
These people (if there is more than one) are authorized to pick up my child from club meetings and can be
contacted if my child gets sick or needs medical attention. (Note if there are any changes in this information,
please send written notification.)
Name:___________________________________________ Relationship:____________________________________
Cell Phone: ______________________________________
Code of Conduct:
I understand that the following individual behaviors make group activities difficult and I will be asked to pick
up my child from club meetings/events if there is a problem:
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Leaving the group without permission
Illness
Inappropriate Language
Refusal to follow the rules
Unsafe behavior
Physical harm to others, facility, or materials
Parent/Guardian Signature:___________________________________________ Date:__________________
Iowa State University Extension programs are available to all without regard to race, color, age, religion, national origin, sexual orientation, gender identity,
genetic information, sex, marital status, disability, or status as a U.S. veteran. Inquiries can be directed to the Director of Equal Opportunity and
Compliance, 3280 Beardshear Hall, (515) 294-7612.