Miss Juneteenth Registration Form

Contestant Name*

First NameLast Name

Emergency Contacts*

Email*

example@example.com

T-shirt size?*

Social media handles*

Education Level*

School Name*

Birthdate*

Date

How did you here about the pageant?*

Favorite school subject?*

Extracurricular Activities *

Please tell us your community service volunteering experiences.*

Accomplishments?*

Career Aspirations?*

Favorite Quote?*

General Requirements~To ensure a rewarding and enriching experience, all contestants ages 5-18 must meet the following criteria:

*Have a 2.5 Minimum GPA (13-18)
*Have no Dependents or become pregnant during the program or reign
*Have no pending or Criminal Record
*Have the Desire to Represent Visions of Worthiness LLC in a positive manner
*Have the Ability to Volunteer on behalf of Visions of Worthiness LLC
*Have Parental Consent to Participate (applicable to contestants 18 and under)
*Have Availability to Attend Pageantry Meetings
*Have Time to Dedicate to Learning an African Inspired Dance opening piece
*Must be a natural born female

Contestants are expected to adhere to the following rules and regulations:
1. Attend all required meetings and rehearsals in preparation of the pageant.
2. Contestants should be willing to attend community activities in their respective areas and serve as Ambassadors for Visions of Worthiness LLC.
3. Contestants must be willing to compete in all required components of the pageant.
4. Contestants must not have any convictions or pending legal issues. Should a Contestant become involved in a legal matter, she will be disqualified from the program. No refunds permitted.
5. Contestants are expected to engage in good character while serving as a Contestant in the program.
6. Contestants and parents/guardians are expected to adhere to the enumerated Rules and Regulations, which Visions of Worthiness LLC. reserves the right to modify, change and amend as needed. Such modifications, changes and amendments will be shared with the contestants and parents/guardians.
7. Contestants and parents/guardians authorize Visions of Worthiness LLC to use names, location (state only and city, if permitted) and images of the contestants for promotional, informational and other purposes as deemed appropriate by Visions of Worthiness LLC.
8. Visions of Worthiness LLC will take precautions to ensure the safety of each Contestant. However, parents/guardians are responsible for Contestants during the program. Visions of Worthiness is not liable for any accidents or lost, stolen or damaged items during the participation of the program. Visions of Worthiness LLC emphasizes the following of these rules and any other standards of conduct set for the program.

Photographic & Volunteer Release

I hereby acknowledge that the information given above is accurate and I give permission to the community for the use of my photographs that are taken by staff in order to use for social media.

I also understand to begin my application process, a $50 non-refundable application fee is required at the time of submission. This fee will be applied to your total registration cost, leaving a balance of $100 which is due by March 7, 2026. Should a contestant become disqualified for reasons outlined in the “Rules and Regulations”, no refunds are permitted. Payments can be made via:
Credit/Debit Card, Cashier’s Check, Money Order, Zelle (980-382-8414)/ Visions of Worthiness (Reayna "Faith" Sanders), Cashapp $vowwellness

Volunteer Candidate Signature*

Parent of Candidate Signature*