ZDay 2010 Event Registration Form

Event Information

The Event Information will be displayed on this website.

Country:*

Description:*

Please provide a short description of the event.

City/Town:*

Zip/Postal Code:*
(not displayed, used for mapping)

Venue Name:*

Physical Street Address:*

Event Website:
(must be a promotional site directly related to the zday event)

Day of Event:*

MARCH_10
MARCH_11
March 12
March 13
March 14
March 15

(We do ask everyone to plan events on March 13, for this is the official ZDATE for 2010. If the 13th is not possible feel free to choose another date.)

Start Time:*

- or -
To Be Announced

Event Contact Information

The Event Contact Information will be displayed on this website.

Contact Name:*
Contact Email:*
Contact Phone:		(please include country and city/area codes)
Additional Contacts:	If there are additional official contacts for the event, please list them below. Name: Email: PHONE: Name: Email: PHONE: Name: Email: PHONE:

Event Page

Would you like to build and display a custom HTML page for your event to show on this website? No Yes

Account Information

This information is kept private. It will not be displayed on the website.
It will be used for your user account, and will also serve as the primary contact information for our administrators.

Email:*		(this email will be used for your account as your login, and may be the same as above)
Password:*		(5-20 characters)