Miss Royal America
ONLINE APPLICATION SELECT ONE:

Contestant First Name Only:      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:

IF PARTICIPATING IN TALENT 1. Type of Talent:      Time:
    Song:

2. Type of Talent:      Time:
    Song:

You must provide us with a cued Cassette or CD of music on Pageant Day

 
Where did you hear of this pageant?
(mailing, advertisment, a friend, etc.)
 
MOTHER/DAUGHTER COMPETITON
One member must be a contestant in this pageant. Judging is based on skit or modeling routine, outfits, & personality. 90 sec. time limit on routine. At least one member must speak at microphone. 20 sec. limit on each speaker. This can be a self introduction or you cn talk about each other.
 
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 give Couto Pageant Productions, Inc. permission to use any photos or video portion of the pageant weekend for television or publicity purposes. We affirm that all information on this application is true and correct.
(Parent must sign - if contestant is under 18 yrs.)


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 & DINNER-
OPTIONALS -
PHOTOGENTIC - $25 each
MODELING - $40 each
OUTFIT of CHOICE MODELING - $50 each
TALENT - $50 each
MOTHER/DAUGHTER - $75
$500 Cash Scholarship Award - $50
TOTAL
TOTAL ENCLOSED
 
Paypal accepted
COUTOPAGEANTS@AOL.COM
 
IMPORTANT - DEADLINES
Application Form with at least $100.00 PAYMENT MUST BE
RECIEVED IN PAGEANT OFFICE 2 WEEKS BEFORE PAGEANT

Applications recieved within those 2 weeks may be subject to a 25.00 late fee