Name:_________________________________ Age:___________________________ Address:______________________________________________________________ Phone #:________________________ Other Phone:___________________________ Email Address:_________________________________________________________ Parent or Guardian Name(s):______________________________________________ School:_______________________________________________________________ Civic/Community Involvement:_____________________________________________ Hobbies:______________________________________________________________ Hair Color:__________________________ Eye Color:__________________________ Favorite Color:_________________________________________________________ Future Goals:__________________________________________________________ Three words that describe you:____________________________________________ _____________________________________________________________________
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REGISTRATION CHECK LIST:
Filled out registration form and signed by parent/guardian.
Check made out to Jackie Watson (or use your credit card- www.paypal.com- to jkwatson4@bellsouth.net) Email picture (.jpg format) for program book to jkwatson4@bellsouth.net.
Email jkwatson4@bellsouth.net for address to mail registration packet.
REGISTRATION DISCOUNTS ARE AVAILABLE FOR EARLY REGISTRATION!
$20 OFF if registration is received by Jan. 30; $10 OFF if by Feb. 12.
For more information email jkwatson4@bellsouth.net
I will not hold the pageant director or Loganville High School responsible for any accidents, damages, injuries, thefts, or losses that may occur before, during, or after the pageant. I understand that bounced checks will incur a fee of $30. I understand that this is a benefit pageant, and that the judges decisions are final. I understand that bad sportsmanship will not be tolerated.
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Parent/Guardian Signature
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Date