APPLICATION FORM- ROYAL ASCOT 2012 INSTRUCTIONS: Download and fill out this form and save it as .

rtf and EMAIL with your entry to the coordinator: PLEASE USE EMAIL ONLY for both entry form and entry. PAYMENT: Electronic Payments will be accepted via MyRWA CONTACT INFORMATION: Name:________________________________________________________________________ Address:______________________________________________________________________ City: _______________________________________ State:_______________Zip: __________ Daytime Phone:__________________________ Evening Phone: _____________________ Email Address: _______________________________________________________________ Name on PayPal Account if different from above . TITLE OF ENTRY: ________________________________________________________ ENTRY CATEGORY: Categories will be used to determine first round judges only. ____ Regency Historical (longer Regency or Mainstream Regency-set) ____ Hot Regency (Very sensual to Erotic Regency, at author's discretion) ____ Wild Regency (Paranormal, Time Travel, other similar Regency) ____ Sweet & Mild Regency (Traditional, Inspirational, Young Adult or other without explicit sex) ********************************************************************** CONTEST WAIVER FOR ENTRY ACCEPTANCE (Do not sign- just type in name and email to coordinator) By submitting my entry to this contest, I certify that I am the author of this work enclosed and that, at the time of submission, it has not been accepted in any form for publication. I have read all the contest rules and regulations and understand that noncompliance with any of these will result in disqualification. I agree to abide by the rules and regulations of the Beau Monde Royal Ascot Contest Competition. I agree to indemnify, defend and hold harmless the Beau Monde chapter, its members, officers, and contest judges from any and all liability in any dispute arising as a result of the judging and handling of my entry(s) and in the conducting, sponsoring, and advertising of this contest. I understand that judging is subjective and that I may receive feedback with which I do not agree. I understand that all decisions of the judges and contest personnel are final and that my failure to agree to the above terms and sign this contestant agreement disqualifies my entry(s). TYPE NAME__________________________________ DATE _____________

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