Registrations | Illinois Extension

Get into the holiday spirit and use nature's bounty to help you build a beautiful wreath. Natural materials such as fresh evergreens, foliage, pinecones, berries, and more will be provided and are included in the registration fee.

Friday, Dec 4 from 4:30 to 6:00 p.m.
Jersey County Extension
201 W Exchange St, Jerseyville
Ages: 8-18
Cost: $20.00 per person.

Registration deadline is Monday, Nov. 30. Early registration is strongly suggested, as space is limited to 12 participants.

Contact Information

First Name

Last Name

Street Address

Street Address 2

City

State

ZIP

Daytime Phone

Evening Phone

E-mail Address

Confirm email address Re-enter your email address to help us send your registration details to the correct address.

Dec. 4 at 4:30pm ($20.00)

[6 of 12 filled]

Photo/Video Permission I grant the University of Illinois Extension, irrevocable permission to record and/or disclose my identity, image, and voice arising out of documenting programs and to use, reproduce and distribute such in whole or in part in video and/or sound recordings, films, photographs, transparencies, webpages, social media, local news media or any other media for any purpose on behalf of the University and Extension without compensations to me and without any right for me to inspect or approve of the finished photograph, video, or audio recordings or other recordings.

Yes

Does participant need reasonable accommodation for this program? If yes, please list below. If none, please put n/a in the box below.

Please tell us how you heard about this program. (You can select more than one option)

Extension Website

Social Media (Facebook or Instagram)

Flyer

Newspaper

Newsletter (email newsletters/eblasts included)

Radio

Friend/Co-worker

Other

Civil Rights Compliance - Participant Info

As part of our commitment to providing equal opportunities in our programming, University of Illinois Extension is required to collect and report overall statistics about the race, ethnicity, and gender of program participants. Your responses are voluntary and appreciated.

Gender

Ethnicity

Race

Total Registration Cost $

Youth Holiday Wreath Workshop | Jersey County

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Contact Information

Civil Rights Compliance - Participant Info