Regenesis Artist Registration Form
Please complete below if you are interested in being a performer or artist. We are currently full on DJ and Music applications, this is for visual, performing arts, installations, poets and other artistic mediums.
Name
First Name
Last Name
Artist or Company Name:
*
Mobile Phone:
E-mail:
*
Website / Social Media Link
Artwork Description:
*
Please give a description of your work, including information about your offering for Regenesis and exchange.
Other Media:
Photography for Promotion
*
Upload a File
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Choose a file
Please provide clear, professional photography we can use for promotion.
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of
Work Sample #2:
*
Upload a File
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Choose a file
Cancel
of
Work Sample #3:
*
Upload a File
Drag and drop files here
Choose a file
Cancel
of
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