UM Regional Form

Contestant Manual CLICK HERE

East South Central Regional Informational Packet CLICK HERE

Host Hotel Reservation Link-CLICK HERE Expires Feb. 16, 2024
Contestant Name:*

First NameLast Name
Birth Date*

MonthDayYear
Select age division (age as of January 1, 2024)*

Universal Baby (0-2)Universal Mini (3-6)Universal Young Miss (7-9)Universal Preteen (10-12)Universal Teen (13-16)Universal Junior Miss (17-20)Universal Miss (21-29) -Married/Divorced/Has ChildrenUniversal Elite Miss (30+)-Married/Divorced/Has Children
Which state title are you competing for?

TennesseeKentuckyOhioIndianaIllinoisRegional Title OnlyProtégé Only
T-Shirt Size*

Youth 2-4Youth SmallYouth MediumYouth LargeAdult SmallAdult MediumAdult LargeAdult X-LargeAdult 2XAdult 3X
Chaperone Name:*

First NameLast Name
Phone Number:*

Area CodePhone Number
E-mail Address:*
The one checked the most.
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Coupon Code (if applicable) :
will be applied AFTER your registration fee is received.
By submitting this registration form, I am acknowledging that I am 18 years or older, and that I have read, understand and agree to the rules and regulations as set forth by Universal Pageant System LLC, Universal Miss. Furthermore, I understand that ALL FEES are non-refundable and non-transferable. Signature and registration fee is required for your registration to be complete. I understand that I or legal guardian/parent of said contestant will be required to sign a COVID-19 Assumption of Risk, Release, and Waiver of Liability Agreement in order to attend the competition. If the competition is forced to cancel we will work diligently to reschedule the event. However, we cannot guarantee an alternative date will be available. *

Clear
Select One
prevnext( X )
Registration Fee$100.00
Required by all competing for their individual state title/awards package. Includes at 4% card payment convenience fee. This fee is required by all and does NOT get deducted from the mandatory pageant fee. Any discounts given will come after your registration fee is received.

Regional Title Only$100.00
Not competing for the overall state title/prize packages. Includes at 4% card payment convenience fee. This fee is required by all and does NOT get deducted from the mandatory pageant fee. Any discounts given will come after your registration fee is received.

Registration Fee- Protégé ONLY$100.00
For girls entering for PRACTICE ONLY- will not compete for the overall state titles/placements. Discounts CANNOT be applied to this division. Required for your application to be completed. Includes at 4% card payment convenience fee.

Subtotal $0.00Tax $0.00Total $0.00

Payment Methods

Debit or Credit Card

First Name

Last Name

Credit Card Number

Card Expiration

Security Code

Please click one of the PayPal options to complete payment and submit the form.

Should be Empty: