Entry Form

           Choose one of the following pageant dates:

Nov6

          Please provide the following contact information:

Contestant Name
Street Address
City
State
Zip/Postal Code
Home Phone with area code
Cell Phone with area code
FAX number
E-mail
Your web site

             Please identify and describe yourself: MC information:

Date of Birth
Sex	Male Female
Favorite Song
Favorite Person
Favorite TV show or Movie
Favorite Pet's Name
Favorite Food
Favorite things to do
Hair Color	Blonde Brown Black Red Gray White
Eye Color	Blue Brown Black Green Gray Violet
Parents Names

              Release

I have read and agree with all rules and regulations of GemStar Pageant Productions. I fully understand and agree that Gwen Connor, GemStar Productions, pageant staff, nor the facility assumes no responsibilities for loss of personal property, accidents, or injuries occurring at the pageant or to and from the pageant. I understand and agree there will be a $30 service fee on any returned checks, NO checks accepted 2 weeks prior to the pageant. I agree to pay all legal fees to collect any debts owed. I have read and understand all the terms of this paper work. I understand no refund will be given unless pageant is canceled or not rescheduled within 6 months. Cash only at the door/registration!