Chimera Registration Form - Self

April is Sexual Assault Awareness Month! Register for a full course during April to get $25 off!

($120 $95/$75 $50 students & seniors)
To take the full 12-hour Chimera course, please select your course dates:
Please note that trans women and non-binary participants are welcome at ALL public courses. Our instructors always prioritize an emotionally safe and inclusive atmosphere for all participants. We also recognize that some participants will feel more comfortable in a class specifically open to all genders. Our next all-gender course will be in spring 2020, dates TBA.
No more full courses are scheduled for 2018. The 2019 schedule should be available soon, so check back!
Full Total
To sign up for Chimera workshops, select a course date(s) below.
No more workshops are scheduled for 2019. The 2020 schedule should be available soon, so check back!
Palentine's Day Chimera ($20/$15 student)
Get a friend to sign up too! Bystander intervention, pairs defenses, and more. No previous Chimera necessary.
Palentine's Cost
Expanding Your Toolbox: Assertiveness for the Trans Community (FREE - donations welcome but not expected)
Designed for the trans community. Supplemental to 12-hour Chimera, but no previous Chimera necessary. Includes de-escalation skills and hate crime discussion.
Active Bystander Training ($30/$20 student)
How to step in when you see harassment or discrimination. No previous Chimera necessary.
Bystander Cost
Verbal Self-Defense for the Workplace ($20/$15 student)
Non-violent strategies for standing up for yourself at work. No previous Chimera necessary. ALL GENDERS WELCOME.
Verbal SD Cost
The following workshops are only open to students who have completed a 12-hour basic Chimera course.
Chimera Refresher ($30/$20 student)
MUST take 12-hour Chimera first. Student-directed review.
Refresher Cost
ADVANCED: Advanced Skills ($30/20 student)
MUST take 12-hour Chimera first. Additional physical and verbal skills not taught in basic course.
Advanced Physical Cost
ADVANCED: Using Your Space ($30/20 student)
MUST take 12-hour Chimera first. Explores personal space, movement, and use of your environment.
Using Space Cost
ADVANCED: Extended Scenarios ($30/20 student)
MUST take 12-hour Chimera first. Extended role-plays that include some physical interactions.
Hybrid Cost
Workshop Total
When did you complete your basic Chimera course?
(Approximate is okay!)

We hope class is a positive and supportive experience for you! We also recognize that many students would appreciate the opportunity to ask questions before arriving at class. Please indicate below if you would like a short individual check-in before class begins. IF YOU CHECK "YES": The Chimera instructor will call you in the evening 1-3 days before the first class session. They will leave a voicemail if you do not pick up. Please note that you are always welcome to reach out during the business day via phone (608-251-5126) or email (chimera@theRCC.org) to discuss.

Yes, I would like an individual check-in call before class begins.
If you would like to make a tax-deductible donation to Chimera, please enter the dollar amount:
Your Total:
Please send me information on scholarships/tuition assistance.
Please select your payment option: *

I will pay online via PayPal/credit card. I will mail a check at least 1 week before class begins. (Total due is listed above. Make checks out to Rape Crisis Center and send to 2801 Coho St #301, Madison, WI 53713.) I am not paying at this time. (A Chimera representative will contact you if they need to discuss this.)
Pay now for Chimera:

USD Total Due
Purpose:

Please do not fill out this form if you are under 18. Your parent or legal guardian has to sign a liability waiver on your behalf.
Should be Empty:

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