Miss Lake Anna Pageant 2025-2026 Entry Form

Miss Lake Anna Pageant Entry Form
Join us as we crown our new Miss Lake Anna queens!

Accepting contestants ages 0-22+. This pageant includes a Ms. division for married or unmarried women ages 23+. Proceeds will benefit Lake Anna Rescue. Residency in Louisa County IS NOT required.

September 7, 2025
1:30 p.m.

Lake Anna Rescue
300 Bumpass Road
Bumpass, VA 23093

DEADLINE to enter: Wednesday, Sept. 3, 5 p.m.

$60 Entry: Includes 1 category: Evening Gown

Optional $15 each

Photogenic (bring 8x10 photo in a clear sleeve with contestant name, age group labeled on the photo, digital photos will not be accepted)

Contestants in the categories for ages 0 to 12 should plan to model in a party dress or formal dress. For these age categories pageant dresses are optional but not required. Contestants in all categories for ages 13 and up should plan to model in formal, evening gowns or pageant gowns.

Age Divisions:

Baby Miss (0-23 months)
Tiny Miss (2-3)
Little Miss (4-6)
Young Miss (7-9)
Pre-teen Miss (10-12)
Teen Miss (13-16)
Miss (17-22)
Ms. (23+)

This is a for FUN pageant, and a for doing good pageant. Join us to have fun and represent the Lake Anna community!
Contestant Name:*

First NameLast Name
Contestant Address:*

Street Address

Street Address Line 2

CityState

Zip Code
Age on date of pageant: *
Age
Date of Birth*

MonthDayYear
Date
Division:*

Baby (Ages 0-23 month)Tiny Miss (Ages 2-3)Little Miss (Ages 4-6)Young Miss (Ages 7-9)Pre-teen Miss (Ages 10-12)Teen Miss (Ages 13-16)Miss (Ages 17-22)Ms. 23+
Parent/Guardian Name(s) (for contestants under age 18):

First NameLast Name
Contestant or Parent/Guardian Phone Number:*
Please enter a valid phone number.
Contestant or Parent/Guardian Email:*
example@example.com
Pageant Rules & Release
All Contestants must be a female who has always been of good moral character, and never been convicted of any crime or have any criminal charges pending against you. You must have never engaged in any activity which could be characterized as dishonest, immoral, indecent or in bad taste. I agree that unsportsmanlike conduct will not be tolerated. If for any reason there is an issue I, my family, and or friends will be asked to leave the property and will not be eligible to compete in the pageant for the following 2 years. I also agree that if chosen as the queen for any age division, I will always uphold the title with the utmost respect. If, at any time, I break these rules I will be asked to surrender my title and return all prizes awarded. I also state that all information given is true and accurate. By participating in this pageant, I grant Lake Anna Rescue, Inc., organizers of the Miss Lake Anna pageant, and organizers of the Lake Anna Rescue Lifesavers Challenge as well as its successors, assignees, representatives, and licensees’ irrevocable permission to take images of me and/or my child during the Pageant and related events. And I give permission to use the images on the Lake Anna Rescue, Inc, Miss Lake Anna and Lake Anna Rescue Lifesavers Challenge website and in other publications, social media or websites as well as any other use the organization deems advisable. I affirm that I am either the adult participating in the pageant and named on this form, or a parent or legal guardian of the child named on this form and have read this release and fully understand its contents.
I understand that there is a mandatory, non-refundable entry fee of $60 for all contestants. The photogenic category is $15 is an optional category for all contestants, but must be paid at the time of application.*

Yes, I understand.
My Products*
prevnext( X )
Contestant Entry FeeEach contestant is required to pay a non-refundable entry fee of $50. This fee is due with your application.
$60.00

OPTIONAL: Photogenic ContestOptional: Photogenic for all age divisions. Score is not included in the competition score. Photos need to be turned in at the pageant date.
$15.00

Total

$0.00
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Miss Lake Anna Pageant Entry Form

Pageant Rules & Release