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Dixieland Dolls and Darlings
2005 National Pageant

Contestant Information

Name

Birthday      Age Group

Address

City      State     Zip

Phone

Hair      Eyes

Hobbies    

Ambition

Parents

Referred by

 

ENTRY FEES

Grand Supreme Package
Includes Beauty, Supreme, Sportswear and Photogenic.
If Entered by July 1, 2005 $495
If Entered by August 1, 2005 $595
All Entries after August 1, 2005
Any discounts won will be forfeited if registration has not been paid by this date.
$695
   
Mandatory Registration
Includes T-shirt and Horse & Carriage Ride
$195
Mini Supreme $75
Beauty/Photogenic Supreme $75
Overall Beauty Supreme $75
Overall Model Supreme $75
Novice Supreme $100
Overall Awards $50 each or all for $150
Side Awards $55
Extra Optional Events $75
Please Check all that apply:
Interview                                       Outfit of Choice
Swimwear                                    Portfolio
Print Model                                
 
Talent $100
Extra Talent $50
     
Check ONE
Level 1       Level 2       Level 3
   
 T-shirt Size

Admission
Everyone except contestants will be required to purchase an Admission Badge
$30
TOTAL $Due
DEPOSIT $150
CREDITS $
BALANCE DUE $

I have read the rules and regulations of this National Pageant and fully understand and agree to abide by them. I hereby release the staff of Dixieland Dolls and Darlings and the facility where the pageant is being held from any theft, injury or loss of property, before, during and after competition. I understand that any act of bad sportsmanship will result in disqualification without refund. I agree and allow any pictures of my child to be used for promotional use.

Signature   Date



    
    

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