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Lace Up for Civics Registration Form

A virtual run/walk to build civic communities. The race will take place from January 20-March 20, 2021! By completing this form, I agree to completing the run and medals will be sent no later than April 1. Bonus accolades if you sign up early and wear your medals during MCCE events!

Name

First Name

Last Name

Verify Email

Billing Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Entry Fee

$30

Donation Schedule

I plan to pay by

Please send checks to the Michigan Center for Civic Education at 306 Townsend St, Lansing, MI 48933 or 7096 Summit Hill Ct SE Caledonia, MI 49316 (Ellen's home).

Check - Please make checks payable to "Michigan Center for Civic Education"

Credit Card

Medal. I would like to receive the medal.

Yes

Liability Waiver.

Please click on this link to read and agree to our liability waiver: https://docs.google.com/document/d/1P-Cf3339f8loviHnN1ZrRhpdZV1qr2yMbtCQjcjiKk4/edit?ts=5ff5dc2e.

Yes

Participants Under 18. Parents/Guardians, please type your name here to waive all liability.

Participants Over 18. Please type your name here to release all liability.

Why is civic education important to you and why do you give?

Disclaimer: All donations below $20 are not tax-deductible. All funds are unrestricted, unless otherwise communicated.

Add 3% to my total amount to help cover the payment processing fees