| Official Pageant Application Name (please use name the applicant goes by) (all fields are REQUIRED) To receive more pageant information, print and complete the entry form below. Mail the form along with the $15 application fee to the address indicated below. Age requirements: Age groups are assigned by contestant�s age on August 1 of the year of competition: Please check the age group you will be entering in: Miss Lexington County 16-19 Teen Miss 13-15 Petite Miss 10-12 Tiny Miss 7-9 Wee Tiny Miss 3-6 Beautiful Baby 3 mon.�24mon. Name_____________________________________________________________________________________________________________ (First) (Last) (Middle Initial) Address _________________________________________________________________________________________________________ (Number & street) (or P.O. Box or Apt.) ___________________________________________________________________________________________________________________ (City) (State) (Zip) Parent's Name(s) _______________________________________________ Home phone ______________________________________________________________ Age / Birth date ______________________________________________________________ Pre-K K 1 2 3 4 5 6 7 8 9 10 11 12 College Other Average: A B C _____________________________________________________________________________________________ Rules and Regulations: Parents of prospective contestants must read the following information and sign if the Official Application is to be considered. The contestant signed below must compete in her correct age group and reside or go to school in the state where she competes. She must give permission to The Miss County Scholarship Committee to use her photographs, speeches, videos, etc., for publicity and future pageant material. In consideration for being accepted as a contestant in this pageant, we the parents and/or guardians of the contestant, individually named below do hereby release Miss Lexington County Scholarship Pageant Committee, its directors, staff, employees and servants from any and all claims and damages directly or indirectly resulting for named contestant participating any other pageant where the contestant will be representing the Miss Lexington County Scholarship Organization. Contestant must never have been married or have a child. The Miss Lexington County Division winner will be asked to sign a contract for the year of her reign, which spells out awards and prizes won, as well as responsibilities of the winner. If the state winner does not sign the contract, she will forfeit her state title, all prizes and cash awards. It is understood that sponsor fees and all other fees are non-refundable without exception. Contestant's Name or Signature _________________________________________ Parent(s) / Guardian(s) Signature _________________________________________ Date _________________________________________ ___ Enclose $15 Pageant Registration Fee ___ Enclose 1 small photo (no larger than 3x5. A school photo or snapshot will be fine) ___ You and Your Parent or Guardian Sign and Date Return Application and $15.00 Registration Fee by June 30, 2003: Miss Lexington County Scholarship Pageant C/O Antoinette Davis P.O. Box 3801 Leesville, SC 29070 |
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