Competition Entry Form

USAM Registration September 14, 2024

Midwest
Delegates Name*

First NameLast Name
Parent/Guardian if under 18 *

First NameLast Name
Delegates E-mail*
Delegates Birthdate *
Age division (as of June 1, 2025)
State*
Age Division *
Age division (as of June 1, 2025)
Phone*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Facebook*
Instagram*
Who Referred you?*
County title option 1*
County title option 2
County option 3
Opt in for texts*

YesNo
Headshot

If you don’t have one at this time please email it to iowa@usamericanmiss.com by September 1
File Upload

Cancelof
I Agree
I have read and agree to the following rules and regulations (located on the National website) and agree to abide by such rules and regulations as explicitly stated.
* I have read and agree to the following rules set forth by US American Miss. In the event that you withdrawl from US American Miss Nationals, you will not receive any gifts/items from sponsors and/or items/products listed within the competition fee.
I agree
Signature*

Clear
Date

MonthDayYear
Date
My Products*
prevnext( X )
Registration Fees (Ages 6+)Must be 6 by June 1, 2025
$99.00

Ages 0-5 as of June 1, 2025 Entry fee cost. No ad page requirement. Shipping cost will be refunded.
$89.00

Subtotal

$0.00

Tax

$0.00

Shipping

$0.00

Total

$0.00
Should be Empty:

USAM Registration September 14, 2024