Beautiful Potheads

Join Betty and create your own one of a kind beautiful flower pot head!

Date: September 8, 2026

Time: 6:30 - 9:30pm

Cost: $18.18

Maximum participants: 10

Instructor: Betty Sigfusson

Additional Information: Can add on another pothead for $13.50

Please use the form below to register.

PARTICIPANT INFORMATION

Participant Name *

Age (must be 18+) *

Phone Number *

Email Address *

Important Information ie; allergies, medications, disability, pronouns, etc:

Would you like to add an additional pothead for $13.50? * Yes, 1 additional pothead
No additional pothead

EMERGENCY CONTACT INFORMATION

Emergency Contact Name *

Emergency Contact 1 - Phone Number *

Emergency Contact 1 - Relationship *

WAIVERS

Waiver of Liability

I agree to release, indemnify and save harmless the Town of Pilot Butte, and its elected officials, officers, employees, agents, representatives, volunteers, and other participants from and against all claims, proceedings and/or actions in respect of any costs, losses, damage or injury arising by reason of my or the dependent registrants’ participation in any activities offered by the Town of Pilot Butte, or by reason of the provision of medical care by the Town to me or the dependent registrants.

Waiver of Liability Agreement * I have read and understand the Waiver of Liability.

Town of Pilot Butte Image Release

I hereby grant permission to be photographed during the program for memorabilia and/or promotional material. I further acknowledge that the Town of Pilot Butte are the owners of all publication materials, and that photos may be used in any exhibitions, public displays, publications, commercial art, and advertising purposes including television without limit or reservation.

Town of Pilot Butte Image Release Agreement * I agree
I do not agree to these terms and do not consent to having my photo taken