Preliminary Pageant: __________________________ Pageant Date: ____________
Name: ____________________________________ Age: _______ DOB: __________
Address: _________________________________ City: _______________ Zip: ______
Telephone: ______________________E-mail Address: _________________________
Parents: ____________________________ Brothers and Sisters: __________________
Favorite Color: ______________________ Favorite Food: ______________________
Favorite Sport: ______________________ Favorite Hobby: _____________________
Color of Hair: ______________ Color of Eyes: _________ Pets: _________________
Entry Fee: $150.00
Sibling Discount = First child regular price - $25 off second child
Mail Entry Form and $50 Deposit to:
D & L Production
40 E Main St*PMB 342*Newark, Delaware 19711
Email: firstname.lastname@example.org Phone: 302-691-8208
Final payment and entry deadline is 14 days prior to pageant. Entry fees may be paid by business check or money order to D & L Production. Entries will be taken the day of the pageant on a limited basis, but must be pre-registered with the Director 48 hrs in advance and a $20 late fee will apply. CASH only at the door. One adult chaperone is admitted FREE with each contestant. Admission is $10 per person.
Children under 5 are free.
Amount paid: ________________ Date: ______________
TRI STATE CINDERELLA PRELIMINARY PAGEANT RELEASE FORM As the parent (legal guardian) of the participant at the Tri State Cinderella Preliminary Pageant, I do hereby agree to abide by the rules and regulations, directives and provisions for winners and contestants as set forth in the official Cinderella Staging Handbook, and by International Productions & Publications, Inc. I agree to hold International Productions & Publications, Inc. and/or the Cinderella Scholarship Pageant, its directors and staff members harmless of any damages or liabilities due to theft, accident or injury during or resulting from me or my child's participation in theTri State Cinderella Preliminary Pageant. I also accept the full responsibility for the regulation of hours and personal activities of the participant. I understand and agree that should war, an act of God (hurricane, fire, tornado, or any other natural disaster) or an act of Man beyond the control of the Pageant (such as terrorist threat or activity) because the cancellation of the pageant that said pageant will be cancelled without benefit of any refund; however, the pageant will be scheduled at another time and location. I also confirm that all of the enclosed information and forms are true and correct to the best of my knowledge room during the pageant (phone calls, valet service, room service, etc.) are my sole responsibility and hereby agree to pay such charges immediately upon checking out of the hotel. FURTHERMORE I hereby state that I have read and understood the rules and regulations governing the payment of scholarship awards, and all other prizes and awards. I affirm that all of the information I have provided, including birth date and place of residence, to be correct and true to the best of my knowledge.
Parent Signature Date