REGISTRATION FORM: Towards Racial Healing Through Multicultural Drumming: Joy, Self-Reflection, and Dialogue      (April 6 OR April 20, 11am-2pm, Elastic Arts)

NOTE: WHILE EVENTS ARE FREE, REGISTRATION IS REQUIRED. DUE TO LIMITED SPACE, YOU WILL BE NOTIFIED VIA EMAIL WHETHER OR NOT YOUR REGISTRATION IS CONFIRMED.  PLEASE EMAIL info@elasticarts.org for any questions or concerns. 

What: A 3 hour block to drum together, self-reflect, and dialogue in the spirit of healing from racism.  (For more details, click HERE)

Where: Elastic Arts (3429 W Diversey Ave #208, Chicago, IL 60647). 

***ACCESSIBILITY NOTE: Participation requires climbing a flight of stairs. The Elastic Arts space is on the 2nd floor, and there is currently no elevator access.***

When: [Two independent sessions] Saturday April 6 OR Saturday April 20 11am - 2pm. You will be asked wheth

For Whom: This event is open to participants who yearn for a healthier multiracial future, and recognize that 

1) none of us are immune from perpetuating and/or being harmed by racism 

2) that healing from racism begins with internal (i.e., self-reflective) work

3) As we invest in this work, we are able to form deeper connections & share in the joy of inclusion

NO MUSICAL TALENT REQUIRED FOR THE DRUM CIRCLE! DRUMS PROVIDED BY FACILITATORS.

Other Info: Lunch available for purchase. Snacks and water will be provided.  Attendance in the full day experience is REQUIRED (late arrivals and early departures are not permitted), and space is limited. So, after checking your availability,  please complete this registration form to secure your spot.

NOTE: While the facilitators have designed this experience to balance psychological safety with stimulating and evocative components, portions of the day may be activating/triggering for some. Please tend to your needs along the way and know all participation is voluntary. 

EVENT IS FREE.  DONATIONS WELCOME TO SUPPORT ELASTIC ARTS, FACILITATORS, AND ARTISTS.  http://elasticarts.org/donate

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Email *
First and Last Name *
How did you hear about this workshop? *
What intrigued you about this workshop? *
We are running this workshop twice: April 6 and April 20. Please indicate your preference and flexibility. *
If you want to order lunch from Chiya Chai online (options range between $10-20), which they will deliver on site at the workshop, would you likely purchase lunch or bring your own? *
If you plan to purchase lunch, comments or requests regarding food (restrictions, allergies, etc.) to help the caterer plan & prepare? *
In terms of your understanding of RACISM, please let us know your level of understanding (1 means "this is new to me / I haven't thought about this issue at all;" and 5 means "I have spent a lot of time working on this issue / I think about it and its impact all the time") *
THIS IS NEW TO ME
I HAVE SPENT A LOT OF TIME WORKING ON THIS ISSUE
Comments on above (in case you'd like to elaborate)
In terms of your understanding of SEXISM, please let us know your level of understanding (1 means "this is new to me / I haven't thought about this issue at all;" and 5 means "I have spent a lot of time working on this issue / I think about it and its impact all the time") *
THIS IS NEW TO ME
I HAVE SPENT A LOT OF TIME WORKING ON THIS ISSUE
Comments on above (in case you'd like to elaborate)
In terms of your understanding of LGBTQIA+ OPPRESSION, please let us know your level of understanding (1 means "this is new to me / I haven't thought about this issue at all;" and 5 means "I have spent a lot of time working on this issue / I think about it and its impact all the time") *
THIS IS NEW TO ME
I HAVE SPENT A LOT OF TIME WORKING ON THIS ISSUE
Comments on above (in case you'd like to elaborate)
In terms of your understanding of CLASSISM, please let us know your level of understanding (1 means "this is new to me / I haven't thought about this issue at all;" and 5 means "I have spent a lot of time working on this issue / I think about it and its impact all the time") *
THIS IS NEW TO ME
I HAVE SPENT A LOT OF TIME WORKING ON THIS ISSUE
Comments on above (in case you'd like to elaborate)
In terms of your understanding of ABLEISM, please let us know your level of understanding (1 means "this is new to me / I haven't thought about this issue at all;" and 5 means "I have spent a lot of time working on this issue / I think about it and its impact all the time") *
THIS IS NEW TO ME
I HAVE SPENT A LOT OF TIME WORKING ON THIS ISSUE
Comments on above (in case you'd like to elaborate)
In terms of your understanding of XENOPHOBIA, please let us know your level of understanding (1 means "this is new to me / I haven't thought about this issue at all;" and 5 means "I have spent a lot of time working on this issue / I think about it and its impact all the time") *
THIS IS NEW TO ME
I HAVE SPENT A LOT OF TIME WORKING ON THIS ISSUE
Comments
In terms of your understanding of RELIGIOUS DISCRIMINATION, please let us know your level of understanding (1 means "this is new to me / I haven't thought about this issue at all;" and 5 means "I have spent a lot of time working on this issue / I think about it and its impact all the time") *
THIS IS NEW TO ME
I HAVE SPENT A LOT OF TIME WORKING ON THIS ISSUE
Comments
This experience is centered on healing from racism and developing a sense of inclusion through self-awareness and dialogue. What are salient identities that you would like to share with the facilitators? Please share any identities that are significant to you (ie. race, ethnicity, age, religion, spirituality, ability, gender identity, gender expression, sexual identity, etc.) Your response to this question is greatly appreciated.
This experience will have been a success if .... *
Are there any other needs, questions or concerns that you would like to share with the facilitators and organizers?
Are you able to consider donating to support Elastic Arts, facilitators, and artists involved with this project? Donations do not affect acceptance into the workshop.
[If yes, you can DONATE HERE:  http://elasticarts.org/donate  ]
NOTE: Donations do not affect acceptance into the workshop.
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Complete registration as soon as possible to secure your spot. Upon completion of this form, you will receive registration confirmation, as well as details about what to expect, as well as other programs. AGAIN, SPACE IS LIMITED SO PLEASE WAIT FOR CONFIRMATION. 

THANK YOU! We are excited to have you participate!
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