Registration - Gaia International

Gaia International 2020 - Registration
$350 USD inc taxes

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Gaia International 2020 - Registration

Upload a clear Headshot for use on our Gallery Page*

Maximum upload size 8MB

Email*

Date of Birth*

Your FaceBook URL

Instagram

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CONTACT DETAILS*

Select Country*

Cell or Telephone Number*

(Please include country code e.g +1 for USA)

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Category you are entering

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Please read and confirm the following

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I acknowledge I am giving permission to Gaia International to use my profile headshot in the public domain*

*Not limited to Gallery, Competition Winner Announcements, Media releases, Social Media (Facebook, Instagram, Twitter) and blogs.

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By clicking Pay Now I agree to pay the registration fee and understand I will be directed to PayPal to complete my registration.

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Name of Guardian*

Cell Number

Cell Number*

Name

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