Contestant Required Forms

Delegate Required Forms

Please fill out the form carefully. Information cannot be saved and edited later. Once started the form must be completed or start from scratch.
DUE IMMEDIATELY!

You will be completing the following required forms:

● Delegate Contact Info

● Rules and Regulations Acknowledgement

● Transportation Release

● Medical Release

● Photo Release

Delegate Contact Info
Delegate Name*

First NameMiddle NameLast Name
Parent/ Guardian Name

First NameLast Name
Birth Date*

MonthDayYear
Age Division*
Age as of July 1st in the year of the National Pageant.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail*
example@example.com
Cell Phone*
Home Phone
Work Phone

Rules & Regulations Acknowledgement
Delegate Name*

First NameLast Name
Parent/Guardian Name

First NameLast Name
Age Division*
I hereby acknowledge I have read, understand, and agree to the following:
- The delegate must be a naturally born female and abide by the pageant residency requirements.
- Delegates must be the following age as of January 1st in the year of the National Pageant:
  - 7 years of age and no older than 9 years of age to compete in the Young Miss Division.
  - 10 years of age and no older than 12 years of age to compete in the Preteen Division.
  - 13 years of age and no older than 15 years of age to compete in the Teen Division.
  - 16 years of age and no older than 18 years of age to compete in the Jr. Miss Division.
  - 19 years of age and no older than 25 years of age to compete and has never been married nor had children in the Miss Division.
  - 26 years of age and older to compete and is currently single or divorced in the Ms. Division. Contestants maybe 19 if they are divorced or with a child.
  - 19 years of age and older and is currently married in the Mrs. Division.
  - 50 years of age and older to compete and is currently married, single, or divorced in the Elite Division.
- State Titleholders may not compete in another state or national competition that will interfere with their ability to compete at the national pageant until they have competed at the national pageant.
- The contestant is required to attend nationals if selected as a State/Regional or Appointed Titleholder. If a contestant is unable to attend nationals, all fees are due in full, and the crown and banner must be sent back to the national office.
- National winners may not compete in another EPIC state or national Pageant until they have aged into another division. Except 2023 EPIC Ambassadors who become eligible to compete for the first time in 2025.
- Contestants and Contestants' parents or legal guardians agree to abide by eligibility requirements and affirm that all information provided is true.
  The contestant agrees to provide an original copy of her birth certificate to verify her age and gender upon request.
- The Emissary Pageants International Congress can change the dates and venue of all pageants as deemed necessary.
- The Emissary Pageants International Congress has the right to refuse anyone entry into the EPIC pageants.
- There will be NO videography or photography allowed at any of the events at the state and national pageant unless otherwise announced.
- Only one parent/guardian is permitted in the dressing room for Junior Division contestants only and will be given a wristband for access.
- Coaches are not permitted in the dressing room for any reason.
- No boys or men are allowed in dressing rooms at any time – not even fathers. NO EXCEPTIONS.
- All headshots must not be over 1 year old.
- Contestants MUST abide by all rules. Parents of any contestant/delegate not observing all rules will be contacted and the delegate will be sent home without a refund.
- All Fees are Non-Refundable.
Contestant/ Parent/ Guardian Signature*

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Date*

MonthDayYear
Date

Transportation Release
Delegate Name*

First NameLast Name
Parent/Guardian Name

First NameLast Name
Age Division*
I hereby authorize the Emissary Pageants International Congress LLC, Mary Oakes and their officials, volunteers or contract labor to transport me and the members of my family and/or friends at all Emissary Pageants International Congress LLC pageants, events, and activities. We hereby agree to indemnify ourselves and hold the Emissary Pageants International Congress LLC, Mary Oakes, its affiliates, and all of their directors, officers, employees, agents, shareholders, partners, members, contract labor and other owners, harmless against any and all claims, actions, demands, liabilities, losses, damages, judgments, settlements, costs and expenses (including attorney’s fees) arising from or related to any traffic violation, collision, accident or loss and any breach or alleged breach by me – the delegate or parent of the delegate – of any provision including but not limited to the representations, warranties, and covenants made by me to the Emissary Pageants International Congress LLC and Mary Oakes.
Signature*

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Date*

MonthDayYear
Date

Medical Release
Delegate Name*

First NameLast Name
Birthdate*

MonthDayYear
Date
Age Division*
Age as of July 1st in the year of the National Pageant.
Parent/Legal Guardian's Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone*
Please enter a valid phone number.
Cell Phone*
Please enter a valid phone number.
Work Phone
Please enter a valid phone number.
Other Phone
Please enter a valid phone number.
Allergies & Medications
Her allergies are:*
Medications she is taking now:*
Her dietary needs are:*
Emergency Contact Information
Name*
Relationship to Contestant*
Daytime Phone*
Please enter a valid phone number.
Evening Phone*
Please enter a valid phone number.
Name*
Relationship to Contestant*
Daytime Phone*
Please enter a valid phone number.
Evening Phone*
Please enter a valid phone number.
Informed Consent, Release Agreement, and Authorization

I understand that participation in Emissary Pageants International Congress LLC pageants and activities involves the possible risk of personal injury, including death, due to the physical, mental, and emotional challenges in the activities offered. Information about those activities may be obtained from the pageant directors and staff. I also understand that participation in these activities is entirely voluntary and requires participants to follow instructions and abide by all applicable rules and standards of conduct.

In case of an emergency involving me or my child, I understand that efforts will be made to contact the individual listed as the emergency contact person by the medical provider and/or pageant. In the event that this person cannot be reached, permission is hereby given to the medical provider selected by the pageant director to secure proper treatment, including hospitalization, anesthesia, surgery, or injections of medication for me or my child. Medical providers are authorized to disclose protected health information to the pageant directors, pageant staff, and/or any physician or healthcare provider involved in providing medical care to the participant. Protected Health Information/Confidential Health Information (PHI/CHI) under the Standards for Privacy of Individually Identifiable Health Information, 45 C.F.R. §§160.103, 164.501, etc. seq., as amended from time to time, includes examination findings, test results, and treatment provided for purposes of medical evaluation of the participant, follow-up and communication with the participant’s parents or guardian, and/or determination of the participant’s ability to continue in the pageant or activities.

(If applicable) I have carefully considered the risk involved and hereby give my informed consent for my child/self to participate in all pageant activities offered by Emissary Pageants International Congress LLC. I further authorize the sharing of the information on this form with any pageant directors, staff, volunteers, or professionals who need to know of medical conditions that may require special consideration in conducting pageant activities. With appreciation of the dangers and risks associated with the pageant and activities, on my own behalf and/or on behalf of my child, I hereby fully and completely release and waive any and all claims for personal injury, death, or loss that may arise against Emissary Pageants International Congress LLC directors, coordinators, and all employees, volunteers, related parties, or other organizations associated with any pageant or activity.

I understand that, if any information I/we have provided is found to be inaccurate, it may limit the care we may provide in an emergency.
Delegate/ Parent/ Guardian Signature*

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Date*

MonthDayYear
Date

Photo Release
Delegate Name*

First NameLast Name
Birthday*

MonthDayYear
Date
Age Division*
Age as of July 1st in the year of the National Pageant.
I also hereby assign and grant to Emissary Pageants International Congress LLC, Mary Oakes, and Mary O. Photography, as well as their authorized representatives, the right and permission to use and publish photographs/film/videotapes/electronic representations and/or sound recordings made of me and/or my child at all Emissary Pageants International Congress LLC pageants, events and activities, and I hereby release the Emissary Pageants International Congress LLC, Mary Oakes, and Mary O. Photography and her directors, staff, agents, related parties, or other organizations associated with any events and activities from any liability from such use and publication.

I further authorize the reproduction, sale, copyright, exhibit, broadcast, electronic storage, and/or distribution of said photographs/film/videotapes/electronic representations and/or sound recordings without limitation at the discretion of Emissary Pageants International Congress LLC, Mary Oakes, and Mary O. Photography. I acknowledge that since my participation in Emissary Pageants International Congress LLC pageants, events and activities is voluntary, I specifically waive any right to any compensation I may have for any of the foregoing.

I understand that Emissary Pageants International Congress LLC, Mary Oakes, and Mary O. Photography are the lawful copyright holders at the moment of creation of all photographs/film/videotapes/electronic representations and/or sound recordings made of me and/or my child at all Emissary Pageants International Congress LLC pageants, events and activities by their staff and photographer. I understand that all material created at Emissary Pageants International Congress LLC pageants, events, and activities will be formally submitted for copyright protection with the U.S. Copyright Office. As such, they may at their discretion limit the use of said materials at any time they so choose. Violation of Emissary Pageants International Congress LLC, Mary Oakes, and Mary O. Photography's licenses is a violation of copyright law and is punishable by a penalty of up to $250.000 under U.S. Law. All violations will be fully pursued possible under the law. Photographs and videos are made available for purchase and are intended for Personal Use only. No Refunds. Commercial licenses are available.

I understand and agree that any photograph submitted or taken using my likeness will become the property of Emissary Pageants International Congress LLC, Mary Oakes, and Mary O. Photography and will not be returned. All submitted photographs are assumed to have been licensed by the contestant for professional and commercial use and include editing rights granted by the creator and are hereby extended those rights to all Emissary Pageants International Congress LLC pageants, events, and activities, Mary Oakes and their graphic designer upon submission. I hereby irrevocably authorize Emissary Pageants International Congress LLC, Mary Oakes, Mary O. Photography, and their graphic designers to edit, alter, copy, exhibit, publish, or distribute photos for purposes of publicizing or any other lawful purpose. Photographs may be utilized for advertising both Emissary Pageants International Congress LLC, Mary Oakes, and Mary O. Photography, and the associated graphic designer's work. I understand and accept that all legal and financial burden regarding copyright infringement of submitted photographs is borne by the contestant and/or their parent or guardian alone.

In addition, I waive the right to inspect or approve the finished product, including any written or electronic copy, wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of photographs.

I hereby hold harmless and release and forever discharge Emissary Pageants International Congress LLC, Mary Oakes, and Mary O. Photography, and their photographer and graphic designer from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or behalf of my estate have or may have because of this authorization.
Contestant/ Parent/ Guardian Signature*

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Date*

MonthDayYear
Date
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Delegate Required Forms