| PAGEANT ENTRY FEES (Check division entering) ____ TEEN ____ MISS $________350.00 OPTIONALS ___Cover Model ($30.00) $. _____________________ ___ Extra Photos x$10.00 ea. $. _____________________ ___ Centerfold Model ($30.00) $. _____________________ ____ Extra Photos x $10.00 ea. $. ___________________ ____ SPECIAL Cover & Centerfold ($50) $. __________________ ___ Portfolio Model ($40.00) $___________________ ___ Talent ($30.00) $_____________________ Sponsor Space x $20.00 ea. $ ____________________ (+ $5 for photo) TOTAL DUE $______________________ Early Registration Discount $-25.00 Amount included with application $_______________ BALANCE DUE at Orientation $_________________ |
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AGREEMENT: I hereby certify that I have read and understand the refund and check policy and contestant rules and regulations for the Miss Barstow Pageant, Inc. and that I do agree to abide by and be bound to the same. I further understand that my acceptance as a contestant is not guaranteed until I have signed the contestant agreement and contract and paid all fees in full. The Miss Barstow Pageant, Inc. or it�s appointed representative shall be the sole judge of the accuracy of the representations made herein. I further waive any claim I may now have or hereafter acquire against the Miss Barstow Pageant, Inc. or any persons affiliated directly or indirectly with the pageant, for any injuries or damages suffered by me during any pageant related activities, and including the activities during the year should I win a title. I also authorize and permit any photographs or videos of me to be used for publicity. My signature below and that of my parent or guardian if I am under 18 years of age, shall constitute this form a binding agreement and contract. � ____________________________________________________________________________________________________ Name of Entrant (PRINT) � ______________________________________________________________________ ________________________ SIGNATURE OF ENTRANT DATE � __________________________________________________________________________________________________ Parent or Guardian (PRINT) � _____________________________________________________________________ _________________________ SIGNATURE OF PARENT OR GUARDIAN DATE ~ Bring any pageant clothing you wish to sell to registration and deadline ~ |
| MISS BARSTOW PAGEANT Type or Print Neatly Judges will see this APPLICATION FORM Division __________________________ � Name _____________________________________________ e-mail __________________________________________________ Age _______ Birth Date _________________________________ Birth Place _________________________________________ Address _________________________________________________ City ____________________________ Zip __________ Home # ________________________________ Cell # ________________________ S.S # _____________________________ Mothers Name _______________________________________ Fathers Name ________________________________________ School ________________________________________ Grade _____ Favorite Subject __________________________________ Employer (if applicable) __________________________________________________How Long? ___________________________ Do you currently hold a title? ________ If yes, what? _____________________________________________________________ Hair Color _____________________________ Eye Color ________________________ Height __________________________ Favorite Food ____________________________________ Favorite Pastime ____________________________________________ Hobbies/Interests/Talents ________________________________________________________________ ______________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ Life Ambition ________________________________________________________________________________________________ Best Asset ____________________________________________ One word that best describes you ___________________________ Favorite Movie ____________________________________Favorite TV Show ____________________________________________ What do you like most about Barstow? _____________________________________________________________________________ � ____________________________________________________________________________________________________________ Besides a parent, who inspires you and why? ________________________________________________________________________ �_____________________________________________________________________________________________________________ Daily Philosophy _______________________________________________________________________________________________ �_____________________________________________________________________________________________________________ Sponsors _____________________________________________________________________________________________________ � _______________________________________________________________________________________________________________ � MAIL TO: MAKE CHECK PAYABLE TO: Miss Barstow Pageant Miss Barstow Pageant P.O. Box 1631 Barstow, CA 92312 ______________________________ Referred by |