Worth county relay for life pageant

Sponsored by: worth county high school

April 24, 2010
2:00 pm
worth county high school gymnasium

(Please type or print NEATLY)

CONTESTANT NAME:

DATE OF BIRTH AGE ON APRIL 24TH

HOME ADDRESS PHONE

EMAIL

PARENTS NAME:

RULES & COVENANTS

*I do hereby agree to follow all rules and regulations of the Worth County Relay for Life Pageant.
*Contestant must compete in the age division they are the day of the pageant.
*Contestant must be a legal resident of Georgia.
*Each age division is open to all Georgia counties.
*Contestants may be sponsored by Family, Friends, or Businesses.
*A $35 fee will be added to all return checks.
*Must agree to get permission from the Director before promoting or representing the Worth Co. Relay Pageant in any other event.
*Contestant must be of good moral character and never have been convicted of a crime.
*The pageant will be conducted under the rules set forth by the Director and Relay for Life and the contestant agrees that the time,
manner, and method of judging the pageant shall be solely within the discretion of the Director and Relay for Life and the judges
decisions are final.
*I agree to assure that the contestant will conduct herself in an orderly manner and well represent the Worth County Relay for Life.
*In the event that the contestant is selected as runner-up, I agree that the contestant will be available to take the title in the event that
the reigning queen should be removed for any reason or otherwise be unable to carry out her duties as reigning queen.
*As the parent/guardian of contestant, I acknowledge that the participation of the contestant in all activities is with consent and
approval.
*Should there be a problem of any kind during the pageant, or related events, the contestant is to go to the Director.
*Any unruly, unsportsmanlike, or any unbecoming conduct by a contestant or any member of her entourage, or any disregard for the
rules and regulations of the pageant could result in immediate dismissal from further competition without refund. Depending on the
severity of the action or behavior, it could result in permanent barrier from future competition of the Worth County Relay for Life
Pageant.
*I release and forever discharge Worth County High School, Worth County Board of Education, Worth County Relay for Life and the
American Cancer Society or any other organization affiliated with the Worth Co. Relay for Life Pageant from any and all injuries,
claims, loss, damages, fees, and cost incurred as a contestant including my entourage in the pageant.

The only appearance queens will have to make is the initial opening of the
Relay for Life Walk held on Friday, April 30, 2010.
Applicant Signature: Date_________________
PARENT \GUARDIAN:_____________________________________________ Date_________________

“GENERAL INFORMATION”

ENTRY FEES - All Divisions $35.00

Includes optionals (Prettiest Hair, Smile & Dress)

Dress is your choice * However…this is NOT a glitz pageant! NOTHING FAKE WILL BE PERMITTED!
Make-up should be age appropriate!

Teeny Miss 0 – 1 Tiny Miss 2–3 Little Miss 4 – 5

Young Miss 6 – 8 Junior Miss 9 – 12 Teen Miss 13 – 15
Miss 16 – 21 (un-married) Ms. 22 – 30 (unmarried) Mrs. 20 – 30 (married)
Young @ Heart 31 – up (single, married, divorced or widowed)

****Application Deadline is APRIL 21, 2010****

We will only be accepting the first 25 applications in each category.
APPLICATION WILL NOT BE ACCEPTED WITHOUT THE FEE, SIGNED RULES & COVENANT FORM & EMCEE PAGE.
No refund unless pageant is canceled.
“Make checks payable to: WORTH COUNTY HIGH SCHOOL RELAY FOR LIFE
Please indicate “PAGEANT” on the memo line.
A $35 fee will be added to all return checks.

Pageant starts at 2:00pm all Teeny &Tiny contestants must be completely dressed by 1:30pm
We encourage all contestants to come early and enjoy the other pageants;
we cannot anticipate the starting time of your age division.
 All Teeny & Tiny contestants will be escorted by their parent or a person designated by their parent during the competition.
 Video Cameras are allowed, but NO CAMERAS please. We will have a photographer.
 SCORES will be mailed 2-3 weeks after the pageant only to those contestants who provide a self address stamped envelope.
You may provide an envelope with your application.
 EACH CONTESTANT WILL BE ALLOWED ONLY ONE HELPER IN DRESSING ROOM at a time, you may swap out
with family members “No Men”. Please be respectful of this rule, space is limited.
 No scheduled practices, however, the gym will be open Saturday, April 24 from 10:00am – 11:00am only for practice.
 Walk is a basic T
 No on stage question or intro - just walk.

$ $ $ $ $ $ $ PEOPLES CHOICE QUEEN $ $ $ $ $ $ $

The One Contestant that collects & turns in the most money by the end of the pageant will be
crowned Relay for Life People’s Choice Queen
SO START COLLECTING TODAY!
We will have a designated area for your collections.
This is a prestigious award so tell all your friends and family to donate to this great cause.
People’s Choice Queen will be notified after pageant is over
and will be crowned at the
Relay kick off Friday, April 30, 2010.
Pageant will be held at the Worth County High School Gym April 24, 2010 at 2:00 P.M. Deadline for applications is April 21, 2010.
Please mail application to Melissa Emerson
C/o Worth County High School Relay for Life Pageant,
1930 Warwick-Ashburn Road, Warwick, Georgia 31796.
Or drop them off at Worth County High School receptionist desk, Monday – Friday 8:00am – 2:30pm.
For more information call Melissa Emerson @ 229-535-4564

Door Admission - $5.00 children under 3 free

(MRS. & YOUNG @ HEART Complete this page)

PLEASE TYPE OR PRINT NEATLY

THIS WILL BE READ BY THE EMCEE

Contestant number ______________ _____________________________________

(we will fill) (Contestant first & last name)

_____________________________________ is the __________ year old daughter

(Contestant first name) (Age)

___________________________________________of ______________, Georgia.

(Parents name)

(Add additional info about spouse, children & grandchildren)

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

She enjoys __________________________________________________________

___________________________________________________________________.

__________________ has _______________ hair and ______________ eyes. Her

(Contestant first name)

favorite TV show is _________________ and her favorite food is __________________.

________________________________ is participating in today’s pageant in

(Contestant first name)

Honor / Memory of ____________________________________________.

(circle one)

_____________________________________ is being sponsored by:

(Contestants first name)

__________________________________________________________________________________________.
This is contestant number ___________ __________________________________.
(we will fill) (Contestants first & last name)
(TEENY – MS. Complete this page)

PLEASE TYPE OR PRINT NEATLY

THIS WILL BE READ BY THE EMCEE

Contestant number ______________ _____________________________________

(we will fill) (Contestant first & last name)

_____________________________________ is the __________ year old daughter

(Contestant first name) (Age)

___________________________________________of ______________, Georgia.

(Parents name)

She enjoys __________________________________________________________

___________________________________________________________________.

__________________ has _______________ hair and ______________ eyes. Her

(Contestant first name)

favorite TV show is _________________ and her favorite food is __________________.

________________________________ is participating in today’s pageant in

(Contestant first name)

Honor / Memory of ____________________________________________.

(circle one)

_____________________________________ is being sponsored by:

(Contestants first name)

__________________________________________________________________________________________.

This is contestant number ___________ __________________________________.

(we will fill) (Contestants first & last name)