Participant Registration For PACE-MI Programs

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PLEASE make sure to click on the "SUBMIT" BUTTON at the very bottom of the form or it WILL NOT SAVE the form! Please fill out the following form to the best of your ability. New participants with registrations received mid-semester may only be able to join certain classes at the start of the following semester, depending on the class instructor. Thank you!

Email *

Please Enter Your First and Last Name *

Example: John Smith

Please Enter Your Current Home City *

Example: Ann Arbor, MI

Please Enter Your Phone Number *

Example: 123-456-7890

Who will be enrolling and participating in PACE-MI? *

Myself

My Children (if any)

Me and My Children

Other:

Please enter the FULL NAME(s) of those planning to participate in PACE-MI programs, as well as their AGE and their RELATION to you:
*

Example: John Smith (45, myself), Jane Smith (12, daughter), James Smith (6, son)

Which PACE-MI classes are you interested in joining? Select all that apply. *

Koro ng Batibot (6-10 Years Old)

Rondalla Estudyantina (Beginners, 11+ Years Old)

Rondalla Cumparsa (Int/Advanced, 14+ Years Old)

Sarunay a Batibot (6-10 Years Old)

Kulintangan a Bagets (Beginners, 11+ Years Old)

Kulintangan a Bayani (Int/Advanced, 14+ Years Old)

Adult Dance Class (All Levels, 14+ Years Old)

Children's Dance Class (All Levels, 6-13 Years Old)

Kali ~ Filipino Martial Arts (All Levels, All Age Groups)

Other:

Required

Please list allergies or medical conditions we should know about you or your family:

Example: Jane Smith (allergy to peanuts), James Smith (allergy to soy, has epileptic seizures)

Please list an Emergency Contact

(Name, Relation to You, Contact Number):

Example: Judy Smith, wife, 234-567-8910

If you can, please tell us about yourself and why you are interested in registering for our programs:

Please describe any previous experience you have with the arts, such as playing an instrument, dancing, design, administration, management, teaching, etc.:

Would you potentially be interested in a volunteer position for our programs such as helping with snack set-up/clean-up, classroom set-up, class assistant/supervision:

YES

MAYBE

Clear selection

By typing your FULL NAME below, you are providing an electronic signature to verify the information you have provided is factual and freely provided.
*

A copy of your responses will be emailed to the address you provided.

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