2022 Miss Junior & Teen Mississippi Hospitality Registration Form

Date

Contestant is a U.S. citizen:

Yes No

Competition Age Groups: Please select one.

Little Miss. Mississippi Hospitality - Pre-Kindergarten to 2nd Grades Young Miss. Mississippi Hospitality - 3rd to 5th Grades Junior Miss Mississippi Hospitality - 6th to 8th Grades Teen Miss. Mississippi Hospitality - 9th to 12 Grades People’s Choice Awards - 6 months to 2 Years Old

Name

First Name Last Name

Age

Date of Birth

Email Address

example@example.com

Address

Street Address (No P.O. Box Please)

Street Address Line 2

City State / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.

Name of Current School

Contestant's Grade

Contestant's GPA (where applicable)

Does contestant currently hold any other royalty title(s)?

Yes No

If so, what is your current royalty title?

List any other previous royalty title(s) and year of any recent pageant(s).

Example: Miss Teen America 2020

List special recognitions, honors you have received:

Provide information about your interests and how you spend your leisure time:

Choose one of the following. Submit your answer. Information will be used for your introduction post on social media page.

Your answer

Upload Contestant's Professional Headshot

Upload Contestant's Birth Certificate

Upload Contestant's Most Recent Report Card (if applicable).

Select Optional Categories: Each category is $100 per category. Place your order in the shopping cart.

Most Photogenic - $100 Miss Congeniality - $100 Active Wear $100 Talent $100 Oratorical $100

I am the...

Parent of the contestant Legal Guardian of the contestant

Mother’s Name

First Name Last Name

Father’s Name

First Name Last Name

Parent’ Primary Email

example@example.com

Parent’s Phone Number

Please enter a valid phone number.

Address

Street Address (If different from contestant)

Street Address Line 2

City State / Province

Postal / Zip Code

Applicant Signature: I certify that all information contained on this application is true and accurate to the best of my knowledge. I have received a copy of the rules, guidelines and information sheet and have read all of the materials and agree to them. I have received clarification to any questions that I may have. I certify that I meet all of the qualifications and agree to abide by the information in the rules, guidelines and information packet. I understand the time commitment and responsibility required if I am crowned as a state titleholder for Miss Junior & Teen Mississippi Hospitality. I further agree that by signing below, I release the Miss Junior & Teen Mississippi Hospitality Pageant, the director, affiliates, partners, sponsors and volunteers from any liability due to loss claim, penalty, lawsuits in any way arising from the involvement of the pageant. For parents under who's contestant is under the age of 18, please sign.

Clear

Applications are due no later than June 1, 2022. Each application must be accompanied by the $25 registration fee. Entry fees are due upon acceptance.

2022 Miss Junior & Teen Mississippi Hospitality Registration Form

APPLICANT’S PROFILE

PARENT'S PROFILE

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