NATIONAL ENTRY FORM
Fees:
Office use ONLY: Sport____ CW:____ Int:____ Color Photo_____ B/W Photo____ Comp____ PM:___ Nat.Photo:____ Tal:_____ OA:_________ Nov:________ Pic:_____ DB:_______ Other:_____ Dep:_____ Via:____ Date:______ Please do not fill in the above
Line-Up Request: Referred by: Contestant's Name: Age Division: Date of Birth: Age: Email: Address: City: State: Zip: Day time Phone Number: Night time Phone Number: Parents: Color Eyes: Hair Color: Something special about me: Ambition: DO NOT MAIL IN A CHECK AFTER THE DEADLINE! WE ACCEPT VISA/MASTERCARD & American Express THRU PAYPAL, ONLINE PAYMENTS. I agree to hold harmless, indemnify and release from all claims Tropical Dream Stars USA, Inc. Productions. DBA: America’s Grand Miss, Martha/Paul Michaud, facility where this pageant is held and everyone associated with this pageant. This shall include but not be limited to any injury, loss or theft. Director has sole authority to disqualify contestants without refund for poor sportsmanship by anyone and the right to refuse entries based on past sportsmanship. I/we agree to abide by all America’s Grand Miss rules and regulations. I agree photos may be used for promotional purposes. No refunds. No transfers. I agree to pay all fees including but not limited to attorney fees in connection with the return of prizes should it be found that I have misrepresented my novice supreme status or age I swear the above information is correct. Signature: Date:
Day time Phone Number: Night time Phone Number:
Parents:
Color Eyes: Hair Color: Something special about me: Ambition: DO NOT MAIL IN A CHECK AFTER THE DEADLINE! WE ACCEPT VISA/MASTERCARD
Something special about me:
Ambition:
I agree to hold harmless, indemnify and release from all claims Tropical Dream Stars USA, Inc. Productions. DBA: America’s Grand Miss, Martha/Paul Michaud, facility where this pageant is held and everyone associated with this pageant. This shall include but not be limited to any injury, loss or theft. Director has sole authority to disqualify contestants without refund for poor sportsmanship by anyone and the right to refuse entries based on past sportsmanship. I/we agree to abide by all America’s Grand Miss rules and regulations. I agree photos may be used for promotional purposes. No refunds. No transfers. I agree to pay all fees including but not limited to attorney fees in connection with the return of prizes should it be found that I have misrepresented my novice supreme status or age I swear the above information is correct.
Signature: Date:
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