Earthdance Creator Registration Questionnaire

Please use this form only if for some reason you cannot register online through our website and Eventbrite. You may copy and paste this questionnaire and your responses into an email and send it to info@earthdance.org, including an explanation of any problems you’ve experienced with the usual registration process. If you are unable to use PayPal to pay the registration fee, please let us know and we can find another way to do this.

*Questions marked with an asterisk are required and must be completed for us to approve your event. Further instructions can be found here at https://earthdance.org/create-an-event/

Thank you for your interest in Earthdance!

  • Primary Contact Person, First Name*

  • Primary Contact Person, Last Name*

  • Primary Contact Email Address*

  • Primary Contact Cell Phone

  • Producing Company/Organization

  • Work Address

  • Work Phone

  • Producer Website

  • Earthdance City or Town*

  • State or Region
  • Country*

  • Virtual Event Start Date/Time/Time Zone*

  • Virtual Event Website URL*

  • Virtual Event Charity Beneficiary Organization Name*

  • Virtual Event Charity Website URL

  • Produced an Earthdance event before? List years and locations

  • Do you agree to the Earthdance Event Producer Agreement?*