Palm Beach Cinderella Preliminary Pageant

Contestant Name*

First NameMiddle NameLast Name

Birth Date*

MonthDayYear

Age*

Competition Age Category*

Parents*

Mom Full NameDad Full Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email Address*

example@example.com

Phone Number*

Eye Color*

Hair Color*

Number of Brothers*

Number of Sisters*

Favorite Toy (Baby Pageant Contestants Only, All Other Contestants Put N/A)*

First Word (Baby Pageant Contestants Only, All Other Contestants Put N/A)*

Hobbies (Big Girl Pageant Contestants, Baby Pageant Contestants Put N/A)*

Sports (Big Girl Pageant Contestants, Baby Pageant Contestants Put N/A)*

Favorite Color*

Favorite Food*

Pets (Number and Type Only)*

Ambition*

Talent Type (Baby Pageant Contestants and Tot Contestants Put N/A)*

Name of Talent Music (Baby Pageant Contestants and Tot Contestants Put N/A)*

***FOR THIS PRELIM, TALENT MUSIC MUST BE SUBMITTED ON A FLASH DRIVE.

A CD WILL NOT BE ACCEPTED**

COMPETITION FEES - MUST BE PAID IN FULL NOW, NO EXCEPTIONS*

$60.00 BABY PAGEANT REGISTRATION FEE : This is for those contestants that are competing as Cinderella Infant, Cinderella Baby, Cinderella Tiny Tot, Little Prince Charming and Prince Charming.$90.00 BIG GIRL CINDERELLA PAGEANT : This is for those contestants that are competing as Cinderella Tot, Cinderella Miniature Miss, Cinderella Miss, Cinderella Teen and Cinderella Woman.

FLORIDA CINDERELLA PAGEANT RELEASE FORM: As the parents (legal guardian) of the participant named above at the Florida Cinderella Preliminary Pageant, I do hereby agree to abide by the rules and regulations, directives and provisions for winners and contestants as set forth in the office Cinderella Staging Handbook, and by the Florida State Cinderella Pageant. I agree to hold Florida Cinderella and/or the Cinderella Scholarship Pageant, its directors and staff members harmless of any damages or liabilities due to theft, accident or injury during or resulting from my child’s participation in the Florida State Finals. I also accept the full responsibility for the regulation of hours and personal activities of the participant. I understand and agree that should an act of God (hurricane, fire, tornado, or any other natural disaster)cause the cancellation of the pageant, that said pageant will be canceled without benefit of any refund; however, the pageant will be rescheduled at another time and location. I also confirm that all the enclosed information and forms are true and correct to the best of my knowledge and belief. I understand that any and all charges to my room during the pageant (rental fee, phone calls, valet service, room service, etc.) are my sole responsibility and hereby agree to pay such charges immediately upon checking out of the hotel at the conclusion of the pageant. FURTHERMORE, I hereby state that I have read and understood the rules and regulations governing the payment of scholarship awards, and all other prizes and awards. By placing my name and date in the spaces provided below, I agree that this is my digital signature.

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PAGEANT FEE AMOUNT*

USDDescription

Polk County Cinderella Preliminary Pageant