Spring Pageant Application

Agriculture America - Title Holder Application

Contact us at (279) 336-0696 for questions on this application.
Contestant Information
Contestant Name*

First NameLast Name
Parent Name (if under 18)

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
Phone Number*

Area CodePhone Number
Age*
Birth Date*

MonthDayYear
Date
Gender*
Eye Color*
Hair Color*
Hobbies*
Goals*
Age Category*

Wee Miss (Ages 2-6)Little Miss (Ages 7-9)Young Miss (Ages 10-13)Jr. Teen (Ages 13-15)Miss Teen (Ages 16-19)Miss (Ages 20-29)Mrs. (Ages 20-55)Ms. (Ages 20-55)Elite Mrs. (Ages 55+)Ag King Title (Ages 2+)
This agreement contains the entire understanding between the Miss Agriculture America Organization and the Contestant / Contestant's Parents or Guardian.
Liability Release*

I also agree to hold the Miss Agriculture America Pageant Directors, Staff, and Venue Location Harmless of any Damages or Liabilities Due to Theft, Accident, or Injury, during or resulting in the participation of this Pageant.
False and Misleading Information*

I affirm that all information provided is true to the best of my knowledge. I understand that False or Misleading Information will be sufficient reason for dismissal from this Pageant.
Negative Conduct*

Negative Conduct will not be tolerated by Participants, Family Members, or Friends before, during, or after Pageant.
Photo Release*

Miss Agriculture America reserves the right to use Photographs, Videos, and Digital or Social Media images of the Contestant and Contestants at any time for Promotional Purposes or Publication.
Signature

Draw with mouse to sign document.
Signature of Contestant (or Contestant's parent or guardian if minor)*

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Agriculture America - Title Holder Application

Signature