Kansas & Missouri State Pageant Registration Form
Contestant Details:
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
E-mail
example@example.com
Age Divisions (Birthdate as September 1, 2024)
Princess (4-6)
Jr. Preteen (7-9)
PreTeen (10-12)
Jr. Teen (13-15)
Teen (16-19)
Miss (20-25)
T-Shirt Sizes
Youth Small
Youth Medium
Youth Large
Youth XL
Adult Small
Adult Medium
Adult Large
Adult XL
Adult XXL
My Products
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Kansas State Registration
$
375.00
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Item subtotal:
$
0.00
Missouri State Registration
$
375.00
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Sweetheart Pageant
Not Eligible for State Title. Practice Pageant.
$
150.00
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Regional Title
If you have entered either the Kansas or Missouri Queen's competitions, then you are eligible for this title. The highest scoring contestant that does not receive the KS or MO title, will be crowned as Miss Midwest. This title will be awarded in each division and will advance to Internationals, along with receiving the queen's prize package.
$
100.00
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Optional- Casual Wear Modeling
$
50.00
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Optional- Fitness
$
50.00
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Optional- Photogenic
$
50.00
Quantity
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Optional- Runway Model
$
50.00
Quantity
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Optional- Spokesmodel
$
50.00
Quantity
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How did you hear about us?
*
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Instagram
Facebook
Internet
Previous Contestant
Other
Magazine
Other
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Will you be willing to recommend us?
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Please give reference of any two people whom you feel:
Full Name
Address
Contact Number
1
2
Payment Methods
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
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