| Official Entry Blank Return To: Sherrie Norris Miss Rodeo Missouri Pageant 22975 Hardy Lane St. Robert, MO 65584 573-336-5066 Fax: 573-336-7032 Email: mrmpageant@yahoo.com |
Division: Miss ____ Teen _____ Jr. ____ Little ______
Name: __________________________________________________________________
Address: _______________________________________________________________
City: _____________________________________ State: __________ Zip: _______________
Home Phone: ______________ Work Phone: ________________ Cell Phone: _________________
Age: ________________ Birthdate: ______________ Email Address: ________________________________
Parents Name: ___________________________________________________________________________
Education:
Name of College or High School: _______________________________________
Major (if in college) : _____________________________
Name of Work: ____________________________________________________________________________
Indicate Further Education and career ambitions:
Rodeo and Horse Show activities:
Club membership:
When and where did you first see a rodeo:
Please give your experience with horses:
Please list Queen Titles you have held if any:
What Contributions do you believe a Rodeo Queen can and should make to the betterment of Rodeo:
Why do you want to be Miss Rodeo?
Name: __________________________________________________________________
Address: _______________________________________________________________
City: _____________________________________ State: __________ Zip: _______________
Home Phone: ______________ Work Phone: ________________ Cell Phone: _________________
Age: ________________ Birthdate: ______________ Email Address: ________________________________
Parents Name: ___________________________________________________________________________
Education:
Name of College or High School: _______________________________________
Major (if in college) : _____________________________
Name of Work: ____________________________________________________________________________
Indicate Further Education and career ambitions:
Rodeo and Horse Show activities:
Club membership:
When and where did you first see a rodeo:
Please give your experience with horses:
Please list Queen Titles you have held if any:
What Contributions do you believe a Rodeo Queen can and should make to the betterment of Rodeo:
Why do you want to be Miss Rodeo?
By my signature on this application, I hereby certify that I have read the regulations governing the Miss Rodeo
Missouri Pageant; that my conduct as a Pageant contestant will be in strict accordance with the regulations
established by Miss Rodeo Missouri Pageant as stated in the official Pageant Rules and Regulations manual. That
I acknowledge these regulations to prevail throughout all Pageant programs, activities, and functions; and that said
regulations pertain to all persons related to my appearance in the pageant.
That I hereby grant permission to The Management and /or The Committee to verify any information contained on
my application.
That I hereby release The Management and The Committee from responsibility of injury or loss to persons or
property involving me or persons related to my appearance in the Pageant, and which applies also to the heirs,
assign,executors or administrators for me or persons relative to my pageant and all officers, directors, and member
individuals and groups of The Management.
That I hereby release title, claim and right to photographs and/or public relations materials involving me to The
Management for use in the Pageant Promotion.
That I hereby certify that I have never been married, had a marriage annulled or have had a child out of wedlock. I
have never been nor am pregnant now.
Failure on my part to disclose this information to local or state officials will automatically disqualify me from
participating in any pageant. Scholarship or prizes of any kind, which I may receive, will be returned to the Pageant.
State Pageant will be released from any and all liability resulting from my action.
That in the event that I receive the Miss Rodeo Missouri, Miss Teen Rodeo Missouri, Jr. Miss Rodeo Missouri or
Little Miss Rodeo Missouri Title, I will complete the tenure of my title in accordance with the aforesaid regulations
and in the best interest of the Miss Rodeo Missouri program; and will relinquish all claims and accouterments
(crown, et al) relating to the title upon the naming of my successor.
That I hereby affix my signature attesting my agreement to the above without reserve.
_____________________________________
Contestant's Signature
If Contestant is under 18 years of age
Approved and Attested by
________________________ ______________________________________
Signature of Parent or Guardian Address
______________________________________
City, State, Zip
Subscribed and sworn to before me, a Notary Public, within and for the county
of ___________________________________
This ____________ Day of ____________, _________
_____________________________________________________ My Term Expires _____________________
Signature of Notary Public
Missouri Pageant; that my conduct as a Pageant contestant will be in strict accordance with the regulations
established by Miss Rodeo Missouri Pageant as stated in the official Pageant Rules and Regulations manual. That
I acknowledge these regulations to prevail throughout all Pageant programs, activities, and functions; and that said
regulations pertain to all persons related to my appearance in the pageant.
That I hereby grant permission to The Management and /or The Committee to verify any information contained on
my application.
That I hereby release The Management and The Committee from responsibility of injury or loss to persons or
property involving me or persons related to my appearance in the Pageant, and which applies also to the heirs,
assign,executors or administrators for me or persons relative to my pageant and all officers, directors, and member
individuals and groups of The Management.
That I hereby release title, claim and right to photographs and/or public relations materials involving me to The
Management for use in the Pageant Promotion.
That I hereby certify that I have never been married, had a marriage annulled or have had a child out of wedlock. I
have never been nor am pregnant now.
Failure on my part to disclose this information to local or state officials will automatically disqualify me from
participating in any pageant. Scholarship or prizes of any kind, which I may receive, will be returned to the Pageant.
State Pageant will be released from any and all liability resulting from my action.
That in the event that I receive the Miss Rodeo Missouri, Miss Teen Rodeo Missouri, Jr. Miss Rodeo Missouri or
Little Miss Rodeo Missouri Title, I will complete the tenure of my title in accordance with the aforesaid regulations
and in the best interest of the Miss Rodeo Missouri program; and will relinquish all claims and accouterments
(crown, et al) relating to the title upon the naming of my successor.
That I hereby affix my signature attesting my agreement to the above without reserve.
_____________________________________
Contestant's Signature
If Contestant is under 18 years of age
Approved and Attested by
________________________ ______________________________________
Signature of Parent or Guardian Address
______________________________________
City, State, Zip
Subscribed and sworn to before me, a Notary Public, within and for the county
of ___________________________________
This ____________ Day of ____________, _________
_____________________________________________________ My Term Expires _____________________
Signature of Notary Public