USA MISS GRAND SUPREME (CONTESTANT WITH THE HIGHEST COMBINED SCORES IN BEAUTY, PHOTOGENIC, & THEME WEAR) 5 ¼” USA RHINESTONE CROWN, CUSTOM USA BANNER, USA RHINESTONE BANNER PIN, SCEPTER, FANCY LONG ROYALTY ROBE, CUSTOM TOTE BAG, & $500.00 CASH

2 USA MISS SUPREMES

0-6 7-UP (CONTESTANTS WITH THE HIGHEST COMBINED SCORES IN BEAUTY, & HIGEST PHOTOGENIC OR THEME WEAR UNDER GRAND) 5 ¼” USA RHINESTONE CROWN, CUSTOM USA SUPREME BANNER, USA RHINESTONE BANNER PIN, FANCY SHORT ROYALTY ROBE, CUSTOM TOTE BAG, & $250.00 CASH

USA MISS MINI-SUPREME (CONTESTANTS WITH THE HIGHEST COMBINED SCORES IN BEAUTY UNDER SUPREMES) 5 ¼” USA RHINESTONE CROWN, CUSTOM USA MINI-SUPREME BANNER, USA RHINESTONE BANNER PIN, FANCY SHORT ROYALTY ROBE, CUSTOM TOTE BAG, & $100.00 CASH

USA MISS PRINCESS SUPREME (CONTESTANT WITH THE HIGHEST COMBINED BEAUTY SCORES UNDER DIVISION QUEEN) 4” USA RHINESTONE CROWN, CUSTOM USA PRINCESS SUPREME BANNER, USA RHINESTONE BANNER PIN

8 OVERALLS

0-6 7-UP (WILL BE DOUBLE-AWARDED IF NECESSARY) CUSTOM BANNER & $25.00 CASH

9 USA MISS DIVISION QUEENS 4” USA RHINESTONE CROWN, CUSTOM USA QUEEN BANNER, & USA RHINESTONE BANNER PIN

9 USA MISS DIVISION PRINCESSES’ USA RHINESTONE TIARA, PRINCESS BANNER, & USA RHINESTONE BANNER PIN

USA MISS ALTERNATES TROPHY

DIVISION PHOTOGENIC ~ CUSTOM PICTURE FRAME DIVISION THEME WEAR ~ CUSTOM TITLE BANNER

DIVISION ANYTHING GOES ~ CUSTOM TRAVEL PILLOW CASE DIVISION OPTIONALS~ TITLE CERTIFICATE

2003 COUNTRY BUMPKIN USA MISS AMBASSADOR (DIRECTOR’S CHOICE)

4” USA RHINESTONE CROWN, USA RHINESTONE BANNER PIN & CUSTOM USA AMBASSADOR BANNER

OVERALL TALENT

CUSTOM TITLE BANNER, BANNER PIN, CUSTOM USA THROW BLANKET, TROPHY, & $50.00 CASH

DIVISION TALENT

CUSTOM TITLE BANNER & TROPHY

1ST-2ND ALTERNATE

MEDAL

NO DOUBLE-CROWNING (EXCEPT WHERE NOTED)!!!

NO ONE GOES HOME EMPTY-HANDED!!!

-----------------------------------------

NAME:_______________________________________________AGE:__________BIRTHDATE:________________________

ADDRESS:________________________________________________________________________________________________

PHONE #:_________________________________EMAIL

ADDRESS:_____________________________________________

DAUGHTER OF:__________________________________________________________________________________________

HAIR:____________________________________________EYES:___________________________________________________

HOBBIES/INTEREST:_____________________________________________________________________________________ ___________________________________________________________________________________________________________

AMBITION:_______________________________________________________________________________________________ ____________________________________________________________________________________________________________

SPONSORED TODAY BY:__________________________________________________________________________________

REFERRED BY:____________________________________________________________________________________________

MS/MARRIED/MOMS

(WIFE/GIRLFRIEND OF:_________________________________________________________________________________

MOTHER OF:_____________________________________________________________________________________________)

I AGREE NOT TO HOLD THE DIRECTOR, VOLUNTEERS, OR THE BUILDING WHERE THE PAGEANT IS BEING HELD RESPONSIBLE FOR ANY ACCIDENTS, DAMAGES, INJURIES, OR LOST/OR STOLEN ITEMS. I HAVE READ AND FULLY UNDERSTAND THE RULES OF THE PAGEANT AND AGREE TO ABIDE BY THEM. I GIVE PERMISSION TO USE PICTURES TAKEN OF MYSELF AND/OR MY CHILD FOR FUTURE ADVERTISEMENTS OF THIS PAGEANT.

PARENTS SIGNATURE ________________________________________________

DATE ________________________________________

$ 100.00 BEAUTY & PHOTOGENIC REQUIRED BY ALL

$ 50.00 THEME WEAR (RED/WHITE/BLUE) REQUIRED FOR GRAND SUPREME

$ 20.00 ANYTHING GOES WEAR (BEAUTY, SPORTSWEAR, WESTERNWEAR, SWIMWEAR, CASUEL WEAR, DENIM WEAR, ETC…)

$ 5.00 EA OVERALLS (CIRCLE EVENTS ENTERED) THEME WEAR ANTHING GOES MOST BEAUTIFUL PHOTOGENIC

$ 10.00 EA EXTRA PHOTOGENIC PICTURES (# OF EXTRA PICS ENTERED _______)

$ _________ TOTAL

$ _________ SUBTRACT DISCOUNTS (IF ANY)

$ _________ DEPOSIT ($75.00)

$ _________ TOTAL OWED AT DOOR (CASH ONLY)

____________________________________________________________________________________________________________

AGE DIVISION __________ CONTESTANT # __________

# TICKETS SOLD __________ REFERRALS __________

(IF YOU WISH TO SELL RAFFLE TICKETS FOR ENTRY FEES AND AWARDS, PLEASE CONTACT DIRECTOR FOR TICKETS AND AWARDS LIST)

TALENT ENTRY FEE (INCLUDES OVERALL TALENT): $ 30.00

2ND TALENT (INCLUDES OVERALL TALENT): $ 15.00

TOTAL: $_________

DEPOSIT ($20.00): $_________

AMOUNT OWED AT DOOR: $_________

NAME: ___________________________________________________________________________________

ADDRESS: ___________________________________________________________________________

PHONE #: ____________________EMAIL: ___________________________________________

BIRTHDATE: ____________________ AGE DAY OF PAGEANT: ___________________

TALENT/SONG: ___________________________________________________________________________ ___________________________________________________________________________________________

DO YOU NEED A MIC? YES NO

IF SO, DO YOU NEED HAND-HELD ON A STAND

SPONSORED TODAY BY: ____________________________________________________________ ____________________________________________________________________________________________

I AGREE NOT TO HOLD THE DIRECTOR, VOLUNTEERS, OR THE BUILDING WHERE THE PAGEANT IS BEING HELD RESPONSIBLE FOR ANY ACCIDENTS, DAMAGES, INJURIES, OR LOST/STOLEN ITEMS. I HAVE READ AND FULLY UNDERSTAND THE RULES OF THE PAGEANT AND AGREE TO ABIDE BY THEM. I GIVE PERMISSION TO USE PICTURES TAKEN OF MYSELF AND/OR MY CHILD FOR FUTURE ADVERTISEMENTS OF THIS PAGEANT.

PARENTS SIGNATURE _____________________________________________

DATE ________________________________________ ________________________________________________________________________________________________

AGE DIVISION __________ CONTESTANT # __________

***PLEASE HAVE MUSIC LABELED AND READY TO GO…YOU WILL TURN MUSIC IN TO “THE ROAD MAN”, DAVID BOEHME, BEFORE TALENT. YOU MAY USE A C.D. OR TAPE***

***PLEASE BE SURE TO PICK UP YOUR MUSIC AFTER TALENT***

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