Baby Miss WV, Little Miss WV, Jr. Miss WV
Baby Miss (0-12 mnths):______ Mini Miss(13-23 mnths)_______ Toddler Miss (2-3)________
Tiny Miss (4-5):______ Little Miss(6-7)_______ Young Miss(8-9)________ Jr. Miss (10-12):______
Name of Contestant: _______________________________________________
Name of Parents/ Guardians: ____________________________________________
Address: ___________________________________________________________
Phone: ______________________E-mail:____________ ______________________
Age:_____________ Age as of 3/24/12:__________________ Birth Date_____________________
Hair Color: ________________ Eye Color:______________ Sponsor(s) If Applicable: _______________________
The following should be answered by Age 4 and up contestants:.
School:_________________________________________________________________
Activities and Awards Honors, Talents, Sports, School & Community Activities:__(Answer if Age Appropriate)______________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________
Favorite Food: __________________________ Favorite Song: _____________________________
Favorite Movie: _________________________ Favorite Color: _____________________________
Favorite Animal: _________________________ Favorite Toy:_______________________
Do you have any brothers or sisters and what are their names? ______________________________________
Do you have any pets? If so, what and what are their names? _______________________________________
Contestants/parents agree to hold harmless the pageant, directors, or volunteers from possible damages through loss, theft, or injury caused by or during her participation, or to and from the pageant or any related event. We also agree to display good sportsmanship at all time during and after the event. I will comply with this release in every way, and that personal data I have submitted is true and correct. Please sign below.
Parent’s signature_______________________________ Date:___________
Address: _____________________________________ Phone Number (s):_________________
Email: _______________________________________
Parent/Guardian Signature: _______________________________
Please return application, non-refundable entry fee (payable to April Lewis), and photo (head and shoulders please)
to: April Lewis, 128 Price Street, Alderson , WV
