printed questionnaire 2017-01-26T17:17:07+00:00

Earthdance 2017 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 into an email and send it to, 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

Thank you for your interest in Earthdance!

  • Primary Contact Person, First and Last Name*
  • Their Email Address*
  • Their Cell Phone
  • Producing Company/Organization
  • Work Address*
  • Work Phone
  • Producer Website*

  • Earthdance 2017 City or Town*

  • State or Region
  • Country*
  • Event Dates (Start-End)*
  • Event Venue Address*
  • Expected Attendance*
  • Ticket Price Range*
  • Charity Organization*
  • Charity Website
  • Produced an Earthdance event before? List years and locations*
  • Do you agree to the Earthdance 2017 Event Producer Agreement*