Empowerment Academy 2022 Spring Pageant Application
Name
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First Name
Last Name
Age
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Date of birth
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Mailing address
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City
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State
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Zip code
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Email
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Phone
Registration and Optional Fees. (You will receive an invoice for payment after application is processes and upon acceptance into program.)
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$150 Pageant registration
- OR - $150 Miss Spring Sunrise registration (A division specifically for women that identify as special needs or disabled, if you desire to compete for this title - Not Required!)
$25 Platform
$25 Talent
$25 Academic, Service or Business Role Model
$25 2nd-hand Couture
$25 Photogenic
$25 Fitness & Wellness
$80 1-hour coaching session
$350 "All in"
Please describe any accommodations you may need:
List three things about you. Can be interests, facts or accomplishments.
Name of parent or legal guardian (if under the age of 18)
Agreement for Participation
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I have read the Contestant Handbook & Agreement for Participation, and agree to abide by the rules as set forth by the Empowerment Academy.
Signature (Must be signed my legal guardian if under age 18)
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Submit
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