Colorado & Utah 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
How did you hear about us?
*
Please Select
Coach
State Director
Another Pageant System
Instagram
Facebook
Friend ( Please specify name- help them win a spot in the Top 11 with 10 contestant referrals that compete)
Other
Please Specify
*
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 Size
Youth Small
Youth Medium
Youth Large
Youth XL
Adult Small
Adult Medium
Adult Large
Adult XL
Adult XXL
Will you be willing to recommend us?
Yes
No
Maybe
What is the friend or sibling's name you are registering with in order to receive the $75 registration discount?
Please give reference of any two people whom you feel will be a great fit:
Full Name
State
Contact Number
Email
1
2
My Products
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Colorado State Pageant
$
375.00
Quantity
1
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10
Utah State Pageant
$
375.00
Quantity
1
2
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10
Partial Payment Colorado
First Payment Due Now Second Payment Due By September 15th ( pay as soon as possible).
$
187.50
Quantity
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10
Partial Payment Utah
First Payment Due Now Second Payment Due By September 15th ( pay as soon as possible).
$
187.50
Quantity
1
2
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5
6
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9
10
Sweetheart Pageant
Not eligible for state title. For practice only.
$
150.00
Quantity
1
2
3
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5
6
7
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9
10
Regional Title
Gives the contestant the ability to go to Internationals if purhased and they receive the highest score in their age division, but only out of the contestants who purchased this opportunity.
$
100.00
Quantity
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Optional- Casual Wear Modeling
$
50.00
Quantity
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Optional- Fitness
$
50.00
Quantity
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Optional- Photogenic
$
50.00
Quantity
1
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Optional- Runway Model
$
50.00
Quantity
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10
Optional- Spokesmodel
$
50.00
Quantity
1
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Registration Fee w/ Friend(s) or Sibling(s)
Both Contestants must register at the same time to receive the $75 off and must pay registration in full.
$
300.00
Quantity
1
2
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10
Payment Methods
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Please click one of the PayPal options to complete payment and
submit
the form.
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