Mississippi Universal Miss and Master
2004 State Entry Form

Name:   Birthdate: Age:
Parents:
Mailing Address:
City: State: Zip:
Home Phone: Work:
Email:
EMCEE INFO:
Hair Color: Favorite Color:
Eye Color: Favorite Food:
Siblings: Favorite TV Show/Movie:
Pets: Hobbies:
Ambition: Best Friend:
Sponsors:

FEES

BEAUTY SUPREME PACKAGE A                                                                     
Includes: Beauty, One Optional Event and one chaperone badge.
Qualifies the contestant for Divisional King/Queen, Supreme Beauty and one Overall.

 $110.00

DELUXE BEAUTY SUPREME PACKAGE B         
Includes: Beauty, and Two Optional Events and one chaperone badge.
Qualifies the contestant for Divisional King/Queen, Supreme Beauty and up to 2 Overalls.

 $135.00

GRAND SUPREME PACKAGE C      
Includes: Beauty, Talent and Two Optional Events, program book and one chaperone badge

 $160.00

DELUXE GRAND SUPREME PACKAGE D 
Includes: Program book, one chaperone badge and ALL Events except cover.

 $200.00
ALA CARTE (or if registering after the deadline)    
Beauty $60.00
Talent $60.00
Sportswear / Casual Wear / Photogenic / Portfolio $50.00
Second Talent / Model $25.00
Cover Model $20.00
Extra Photos for Photogenic $5.00
Program Book $10.00
Admission 
Adults ____ X $5.00, Children (4-10 years) ___ X $2.50		 $Due
Media Pass  
Camera: __ X $10, Video: __ X $10, Camera and Video: ___ X $15 		$Due
Late Fee $25.00
Subtotal $Due
Sibling Discount - Sibling enters package A, B, C or D for $100 when the first enters package D. (Enter $100 in the appropriate package above)  
PRELIM DISCOUNT:
 (Half face value for state - full face value for Mini-National)		 $Value
Deposit ($75 Minimum Due)  $75.00
Balance Due at the Door (Cash only - no exceptions) $
Talent 1: Talent 2:
Please Check all that apply:  
Casual Wear:      Sportswear:     Portfolio:    Photogenic: Talent:
I agree to hold harmless the Directors, staff and location of the Universal International Pageants from liabilities due to accidents, injury, theft, death, etc, while participating in any Universal International activity.  Good Sportsmanship is a must at all times. There are No refunds. The judge's decisions are final! 

Signature of Parent or Guardian:
Date:


Sibling package does not include another chaperone badge or a program book. Sibling discount is 50% off so any discounts will be redeemed at 50% of their face value.  **REFERRALS: You will be given $20 credit for each referral that is not on our mailing list.  Your name must appear on the referral line and the deposit received by the due date to be counted.  Referral credit will be deducted from your balance due at the door.  Refer 4 contestants and enter pkg A free.  Refer 5 contestants and enter pkg B free.  Refer 6 contestants and enter pkg C free.  Refer 7 contestants and enter pkg D free.  Payment options:  We do not accept personal checks.  Cashier checks, money orders, cash and PayPal only. We can accept credit card payments via PayPal.  We will not accept PayPal less than 14 days prior to the event.  Please contact the director for more information. 

Entry Form will be accepted ONLY with a $75.00 Non-Refundable deposit, which will be applied to your fees. This applies to all contestants.
We only accept: MONEY ORDERS or CASHIER CHECKS!
NO PERSONAL CHECKS ACCEPTED!!! NO EXCEPTIONS!!

Referred By:

DEADLINE: Entry Form, Deposit, Roster Photos, Ads and Ad Fees & are due 14 days prior to the pageant.


Email: TOYAKING123@aol.com

 

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