_____ Contestant #'s
Name:_____________________ AGe:____________________________
Date of Birth_________________Age Division:____________________
Address:___________________________________________________
E-Mail:_____________________________________________________
Hair Color: ____________ Eyes: _____ Best friend:________________
Parents:___________________________________________________
Sisters:______________________ Brothers_______________________
Favorite Food:_______________Favorite Person:_________________
School Attending:___________________________________________
Ambitions:__________________________________________________
___________________________________________________________
Hobbies:____________________________________________________
___________________________________________________________
Sponsored By:_______________________________________________
Door Admissions; General admission $5 each under 3 free
I understand and agree that the Directors nor the place of staging, will be held rresponsible for any accident,
injury, theft or personal loss incurred at the pageant or in transit to and from the pageant. I also agree and understand
that the Judge's decisions are final and poor sportsmanship will NOT be tolerated.
__________________________
Parenmts/Guardin Signature
Entry Fee $75________
EarlyBird #1 By January 15 $50_______
If you pay day of pageant you are subject to a $10 late fee
Mail entries to: Vickey DiMattia P.O. Box 1241 Independence La 70443
