Indiana Beauties State Form

Indiana Beauties State Pageant Registration Form

Please fill in the form below. THIS WILL BE READ ON STAGE!
Full Name*

First NameMiddle NameLast Name
Division*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail*
Birthday*
Hair Color*
Eye Color*
Parents*
Favorite TV Show*
Favorite Food*
Hobbies*
Accomplishments*
Future Ambition*
Pageant Sponsors*
Referred by*
Referred the following:*
I will be participating in the following optionals. These CAN BE DOUBLE CROWNED!*

Talent (2 min time limit) $50.00Community Service/ Platform Presentation $50.00Cheer (2 min time limit) $50.00Casual Wear Modeling $50.00Overall Party Wear $40.00Overall Most Beautiful $40.00Overall Photogenic $40.00Overall Outfit of Choice $40.00Additional Photos $10.00 eachREQUIRED FEES- $275.00 STATE ENTRY FEE (DOES NOT REFLECT DISCOUNT WON- PLEASE SEE NEXT QUESTION FOR DISCOUNT AMOUNT)REQUIRED FEES- $50.00 1/2 page program adAdditional Talent #2 $40.00Additional Talent #3 $30.00Additional Cheer #2 $25.00Additional Casual Wear #2 $40.00Additional Casual Wear #3 $30.00Additional Community Service/ Platform $25.00
I won the following title at a preliminary and am entitled to a discount- Only one discount per entry*
Required State T Shirt $20.00 Toddler- Adult XL, $25.00 AXXL+*
I understand the following: Pageant Cash is awarded at each preliminary to contestants. PLEASE NOTE- The pageant cash does not accumulate to pay for pageants or for the state pageant. Only the highest value of pageant cash awarded will be valid. i.e. If you are an ambassador you receive $50.00 off of state plus $25.00 off of a preliminary. If you go to that preliminary and win a queen title, you are awarded $100.00 pageant cash thus canceling the $50.00. Pageant cash must be redeemed within 60 days of the pageant date by sending state intent form or lose 50% of its value. Pageant cash is non transferrable and not redeemable for cash award.*

YES
Payment Plan Needed? A detailed bill will be sent after all optionals selected.*

YesNo
Date I can begin making payments **ALL BALANCES ARE DUE DECEMBER 31, 2013***
I need to make the following # of installments*
I understand all payments are non refundable*

YES
I understand that a 1/2 page ad sale is required for the program book. If not sold, $50.00 will be added to my final balance. I understand that I can sell more and that the contestant with the most ad sales will be crowned the Cover Model. I understand this is a double crownable title.*

YES
I understand that $50.00 intent deposit is required with this form to hold my spot at state and to secure pageant cash awarded. I plan to*

Pay via paypal to kybeauties@gmail.comPlease send me a paypal invoiceCall and pay by credit card over the phone (1-888-563-3348 ext 1)Mail payment (MUST BE POSTMARKED within pageant cash limits)
I understand that all information and paperwork sent to me including all forms and the ANSB National handbook is Copyrigthed material and legal property of ANSB, LLC. Should I be found copying said material or duplicating a replica of such in any fashion other than to promote ANSB that my title can and will be forfeited and that ANSB, LLC can and will take legal action to protect its property.*

YES
I, the undersigned, do hereby release, authorize and permit my photos to be used for publicity, promotional, or commercial purpose in conjunction with the Pageant. I also release America’s Natural Supreme Beauties and ANSB,LLC from any responsibility or claim due to injuries suffered by myself or guests; or personal property damaged or lost during travel from home to the place of the contest and during participation times at the Pageant. I also agree to abide fully by the Rules and Regulations of the Pageant and by the decisions of the judges. I understand there will be an Admission fee for all my guests attending the Pageant. The Pageant has the right to refuse any contestant for not complying with the Rules and Regulations of the Pageant. Should my child win a title, we will comply by rules for title holders and acknowledge that said title can be taken away if rules are violated. I understand there will be absolutely NO refunds given, only credit if due to an illness. (Submitting the form online serves as the electronic signature.)*

YES
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Indiana Beauties State Pageant Registration Form