About Us
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Point of Light Award
In The News
Annual Pageant
Our Ambassador Program
Contact Us
Pageant Application


Name :
Age Division :
Address :
City :
State :
Zip Code :
Age :
Birthdate :
Phone :
E-Mail :
Parents Name :
Hair Color :
Eye Color :
Favorite Show :
Favorite Subject :
Favorite Vacation :
Hobbies :
Ambition (One day I would like to be) :
Sponsor :
Child T-Shirt Size :
Adult T-Shirt Size :
I do hereby agree to abide by the rules and regulations of the pageant. I, the undersigned, fully agree and understand that the pageant or the facilities where the pageant is being held is in no way responsible for any injuries or accidents that may occur. I agree that the judge's decision will be final and that my family and I will show forth good conduct at all times. I release consent for any photographs and videos taken to be used by the pageant for promotional purposes.
Parent Signature :

Comments :

Security Code: