Miss Southlake Westlake Registration Form

Miss Southlake Westlake Registration Form

Southlake/Westlake Registration Form

Thank you for your interest in the Miss Southlake/Westlake Competition on September 13, 2025! Please Complete the Registration Form to compete at the Competition. If you have any questions, please contact DaNae Couch Lowe at DaNae@MissSouthlake.org.
Candidate Contact Information

Please include your contact information so that we can stay in contact with any questions that may arise regarding the paperwork submission.
Name*

First NameLast Name
Birthday*

MonthDayYear
Date
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Alternative Contact Information

Please designate an alternative contact. This can be a parent, sibling, or friend.
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com

Miss America Proof of Registration

All Miss and Teen delegates must register with Miss America once per competition cycle. If you have not competed in a local competition yet this year, register at https://www.club.missamerica.org/ma-membership.
Screenshot of Miss America Registration Confirmation*

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Miss America Contract

The Miss America Organization requires each contestant complete the Miss America Contract and submit verifying Eligibility Information. Please upload proof of submission of the contract.
Proof of Miss America Contract*

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Miss America Eligibility

Please verify that you have reviewed, comply with, and submitted supporting documentation with respect to the Miss America Eligibility Criteria.
The contestant must be a Citizen of the United States of America.

Miss America 18-28: must be NO OLDER than 28 on September 30, 2026, and no younger than 18 on Sept 1, 2026.

Miss America’s Teen 14-18: must be no YOUNGER than 14 by September 1 and no older than 18 on Sept 30, 2026.

Contestant Must Also Meet One of the Following:

Geographic Eligibility (Residency): The contestant must be a legal resident of that State by the first at least one hundred and twenty days (120) prior to competing in the Competition.

Geographic Eligibility (Employment): The contestant must be a full-time employee (full-time defined as an average of no less than 40 hours per week for a single employer) working in the State or geographic area of the Local Competition for a minimum of one hundred and twenty days (120) immediately preceding the Local Competition.

Geograpgic Eligibility (Education Status): The contestant must be enrolled as a full-time student (full-time student status as determined by the school) at an accredited college or university located within the State by the first day of the Local Competition.

For more information, please review Sections 2 and 3 of the Miss America contract.
I swear or affirm that I have reviewed the foregoing Eligibility Requirements and have submitted to the Miss America Organization documentation supporting the applicable requirements as defined in the Miss America State/Local Contract.*

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Rebel Athletic x Miss America

The Miss America Organization partnered with Rebel Athletic to promote women's heart health. To help, Rebel Athletic created a line of Red athletic wear that will be used for Health & Fitness. A percentage of the proceeds benefit scholarship if you use code: MAOTXGB.
To shop the Rebel Athletic x Miss America collection, please view it here.
Acknowledgement of Rebel x Miss America*

Yes, I acknowledge the above.I have a question regarding the above.

American Heart Association x Miss America
Miss America requires all Miss and Teen candidates raise $30 for the American Heart Association per local competition. Proof of fundraising should be sent to DaNae@MissSouthlake.org by Friday, September 5.
Acknowledgement of American Heart Association x Miss America*

Yes, I acknowledge the above.I have a question regarding the above.

Paperwork Information

Need Instructions for the Resume and Fact Sheet? Email DaNae@MissSouthlake.org.
Headshot*

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Fact Sheet*

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Community Service Initiative*

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Talent or HERStory Performance

All candidates will either use a performance talent or HERStory presentation that is 90 seconds. Please provide the relevant details below.
Performance Type*

DanceInstrumentalTwirlVocalHERStoryMonologue/Slam PoetryOther
Name of Performance Piece*
Do you require any specific production elements (Mics, cleanup of materials, etc.)? If so, please provide more information below.*
Talent Music (If Any)

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Registration Fee

Early Bird Registration applies for complete registrations and submissions prior to August 15. Unless the Early Bird Rate applies, the Miss Southlake & Miss Westlake entry fee is $150, unless you upgrade to include an optional, full-page ad in the program book ($200).
PayPal: DaNae@MissSouthlake.Org

Venmo: @DaNae-Couch

Check: Payable to Miss Southlake Scholarship Org and mailed to 2415 Creekside Circle N Irving, TX 75063
Have you submitted your registration Fee?*

Yes, I have paid.No, I will pay following submission of the form but prior to September 8.
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