Queens of New England
ONLINE APPLICATION CLICK ARROW TO SELECT DIVISION:    

Contestant Name:      Date of Birth:
Age at time of this pageant:      Home Phone:
Complete Mailing Address:
                                          City:     State:      Zip Code:
Parents Names (if minor):      Email:
Hobbies & Special Intrest:
Ambition for Future:

Dinner Party  fee is - $24 for children
                                                                   $30 for adults
Everyone who attends will enjoy an evening of great food, friendly faces, festive dancing, and each contestant will receive a commemorative party favor!
(order tickets below)
Please RESERVE the following TICKETS
 CHILDREN - (amount) 3 and under Free
     ADULTS -
 
You may attend the Pageant & not the dinner,
or you may attend the dinner without attending the Pageant
 
*** All Dinner Party Fees MUST be paid in full 2 weeks before the event!!!
 
We hereby have read and understand all the RULES & REGULATIONS set forth by the pageant and release the Directors and Staff from any and all claims for damages or for injuries we may sustain while participating in any of the pageant activities.
We affirm that all information on this form is true & correct
(Parents must sign - if contestant is under 18 years of age)


Parent Signature                                                   Date


Contestant Signature                                             Date
 

NOTE:
YOU CAN MAKE DINNER RESERVATIONS
NOW AND PAY LATER.

Any Questions Call: (203) 922-1066
or Email: CoutoPageants@aol.com

SPONSORS are businesses or individuals who can pay your entry fees. This may be parents, friends or businesses. Remember that you can sponsor yourself if you wish!!! Up to 4 sponsors names will be announced during the pageant. This is a tax deduction for any business.

SPONSOR'S NAMES - if any (will be mentioned during pageant):
 
SPONSOR ENTRY FEES
PAGEANT (Past Couto Contestants) -
PAGEANT (NON Past Contestants) -
OPTIONALS
PHOTOGENTIC - $30 each
MODELING - $50 each
PAIRS MODELING - $60 each pair
TOTAL
TOTAL ENCLOSED
 
PayPal Accepted:
CoutoPageants@aol.com

OR MAIL A CHECK TO: Queens of New England
                                           P.O. BOX 556, SHELTON, CT 06484
 
IMPORTANT
Registration From with at least with $25 Deposit MUST BE RECEIVED
IN PAGEANT OFFICE BY 2 Weeks Prior to event
NOTE: If recieved after deadline, please ADD $20 Late Fee