Starz N Glitz Registration

Customer Details:

Contestants Name*

First NameLast Name

Guardian Name on Facebook*

First NameLast Name

Phone Number*

E-mail (important info sent here)*

example@example.com

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Contestants Birthday *

Age Division*

Contestants Hair Color*

Contestants Eye Color*

Contestants Favorite Book or TV Show*

Contestants Hobbies and or Goals*

Jackpot Photo Event Available. Please list which photos and quantity you plan to enter. Categories: Glitz - Natural - Black/White - Print Model - Stage Shot. $10 per photo. Winner will receive half of the pot in each category in designated supreme breakdown. *

Will you be participating in Celebrity Supreme (Peoples Choice)?*

YesNoPossibly

How many wristbands will you need at the event? $10 per person except contestants and children age 2 and under. *

Please understand the all inclusive package is $140 and includes everything except for wristbands and jackpot photo event. There are no additional door titles. Please select how you will be paying your deposit below. Deposit of $60 is required to hold your place. Remaining balance will need to be paid by January 15th. Jackpot photo add on can be done at the door if preferred.*

Venmo: Amanda-Carter-2015Cashapp: $AmandaCarter18

Please leave any notes we may need to know about here:

Keep an eye out on our FB page as well as the event page! We will make all updates on our event page.

How did you hear about us?*

Starz N Glitz Registration - Feb 7 2026