America's Liberty Miss & Mr
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 Interest:
Ambition for Future:

 We will have a Royal Gathering after the award ceremony for those who wish to get together and form new friendships over cake!  
 
 
Where did you hear of this pageant?
(Mailing, advertisement, a friend, Facebook, etc.)
 
NOTE: You do not NEED TO COMPETE in ANY
OPTIONAL COMPETITIONS in order to
WIN Pageant or High-Point Pageant Titles.
 
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
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 5 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 -
OPTIONALS
PHOTOGENTIC - $25 each
MODELING - $50
OUTFIT OF CHOICE - $50
TALENT - $50
PATRIOTIC WEAR - $35
TOTAL ENCLOSED
 
We Accept Payments Through PayPal.com
COUTOPAGEANTS@AOL.COM
 
IMPORTANT
Registration Form with $50 Deposit must be received in Pageant Office by February 21, 2016. A $25 late fee may apply if received after this date.