UM Reg Form

*Kentucky *West Virginia *Illinois *Indiana *Ohio

Universal Miss East South Central Regional (Season 6)

February 20-22, 2026

The Center for Rural Development

Somerset, KY

Regional Contestant Information Packet - Click Here
Contestant Name:*

First NameLast Name
Birth Date*

MonthDayYear
Select age division (age as of January 1, 2026)*

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?*

KentuckyWest VirginiaIllinoisIndianaOhioProtégé
T-Shirt Size*

Youth X-SmallYouth 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
Referral 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*

Registration Fee$100.00

Required by all who will be competing for their 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.

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Subtotal $0.00Tax $0.00Total $0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

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