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EMA 2021 Pre-Registration Form
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* Indicates required question
Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
A valid mobile number that we can reach you in case of emergency.
Your answer
Preferred Role
*
Lead
Follow
Are you registering as a couple?
*
Yes
No
If yes, please provide full name and email address of your partner (he/she must fill their own form):
Your answer
Please list previously attended encuentros (if any)
Your answer
Please provide any additional information relevant to this event that can help us to get to know you better:
Your answer
Are you vaccinated?
*
Yes, fully!
Yes, but only one dose!
Will be by October 1, 2021.
No, I don't want to be vaccinated!
I prefer not to answer.
Required
Is your partner (if applicable) vaccinated?
Yes, fully!
Yes, but only one dose!
Will be by October 1, 2021.
No, he/she doesn't want to be vaccinated!
He/she prefers not to answer.
Are there other milonguero/milonguera friends that you would like us to see at EMA 2021? If so, please give us their names below:
Your answer
Send me a copy of my responses.
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