Pottery with Personality

DOROT Westchester

invites you to join us for

Pottery with Personality

Roll up your sleeves for a playful pottery session!

Create your own bobble head—of anyone you choose—and enjoy a fun, hands‑on afternoon with others.

Your piece will be fired by our local partner and you will need to return to DOROT’s White Plains office to pick up on another day.

We’re excited to get a head on this project with you!

Wednesday, March 11th

2pm - 3:30pm

DOROT Westchester

925 Westchester Ave. White Plains, NY

This program is for adults 60+

Registration required.

Please complete this form.
Name *

First NameLast Name
Gender Identity*
Preferred Email*
example: infowestchester@dorotusa.org
Email for Reminders:
IF OA registers by PHONE but does provide an email for SF account.
Preferred Email type:*
Preferred Phone # *
Preferred Phone type:*
Secondary Phone #
Secondary phone type:
I have participated in a DOROT event before.*

YesNo
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Birth Year*
This program is for adults 60+
Birth Month
Birth Day
Terms of Participation:
Terms of Participation:

Before we finish your registration, I need to read you a brief statement about program content. This is the same agreement participants see when registering online. It explains that all program materials belong to our organization and can’t be used or shared without our permission. After I read it, I’ll ask if you agree so we can complete your registration.
The content of this program is the property of DOROT, Inc. and is intended solely for the personal, non-commercial use of authorized participants. All rights are reserved. Any recording, screen scraping, copying, storage, display, or distribution of this content without DOROT, Inc.'s express written permission is strictly prohibited. Unauthorized use may subject violators to civil and criminal penalties.*

I agree to these terms.
DOROT staff, read this to participant: The content of this program is the property of DOROT, Inc. and is intended solely for the personal, non-commercial use of authorized participants. All rights are reserved. Any recording, screen scraping, copying, storage, display, or distribution of this content without DOROT, Inc.'s express written permission is strictly prohibited. Unauthorized use may subject violators to civil and criminal penalties.*

DOROT STAFF read this as part of the registration by phone and VERBAL AGREEMENT was received.
Please verify that you are human*
Please check your responses carefully for accuracy. You will not be able to revise this form after submission.
Should be Empty:

Terms of Participation:

Terms of Participation: