Happy Birthday America 2024 Pagent Registration Form

Full Name*

First NameLast Name
Parents Name If minor

First NameLast Name
E-mail*
Please input a valid email id
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Date of Birth*

MonthDayYear
Date
Age on Pagent Day*
Select Age Division - Complete as of age on June 30th, 2024*

Baby 0 - 23 moLittle 2 - 4 yearsTiny 5 - 7 yearsYoung 8 - 9 yearsPreteen 10 -12 yearsJunior 13 -15 yearsSenior 16 - 19 yearsMiss 20 - 29Ms. 18 & up
School Attenting*
Hair Color*
Eye Color*
My Hero*
Hobbies/Interesting Facts*
Sponsored By*
I have read, understand and agree to the rules and regulations for the Miss Happy Birthday America Pageant.
Contestant Signature/ Parent/Guardian if under 18*

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Printed Name

First NameLast Name
Date

MonthDayYear
Date
Choose your entry and add ons here:*
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Entry Fee All Ages. Received Prior To April 15th$50.00

Entry Fee All Ages Received After April 15 but before May 15th$60.00

Entry Fee All Ages Received After May 15th but before June 15th$70.00

Photogenic $15.00
Optional Add On

Quantity

Patriotic Wear$25.00
Optional Add On

Total $0.00
Should be Empty:

I have read, understand and agree to the rules and regulations for the Miss Happy Birthday America Pageant.