Miss Southern Beauty USA TM
Application
Name:__________________________________________________
First Middle Last
Address:________________________________________________
City:______________ State:___________ Zip Code:_________
Home Phone #:______________ Cell # ___________________
Date of Birth:___________________ Age:____________
Hair Color:_______________ Eye Color:_______________
Height:__________________ Favorite Color:_____________
Parents:________________________________________________
Parents Address:_________________________________________
Parents Phone # :______________________________
Siblings:________________________________________________
Husband: ________________________________________ (if applies)
Children: _________________________________________ (if applies)
Email Address:___________________________________________
Grade in School:_________________ School:__________________
Honors & Awards:___________________________________________
_________________________________________________________
Ambition:_________________________________________________
_________________________________________________________
Hobbies:__________________________________________________
_________________________________________________________
Executive State/National Director - Marla Massengale 864-905-1402
Email : misssouthernbeautyusa@yahoo.com
I HEREBY APPLY AS A CONTESTANT, FOR THE MISS SOUTHERN BEAUTY USA STATE AND/OR NATIONAL PAGEANT WHICH WILL BE HELD IN GREENVILLE, SC. I HEREBY RELEASE, UNCONDITIONALLY AND FOREVER, ANY CLAIM AGAINST THE SOUTHERN BEAUTY USA PAGEANT, STATE/NATIONAL COMPETITION,CEO, STATE/NATIONAL DIRECTOR AND THEIR RESPECTIVE OFFICERS, DIRECTORS, PARTNERS, EMPLOYEES, AGENTS OR ASSIGNS. I HAVE READ THE ABOVE STATEMENT AND AGREE TO EVERY SENTENCE AND UNDERSTAND THAT THE MISS SOUTHERN BEAUTY USA PAGEANT, THE CEO, THE EXECUTIVE DIRECTOR, AND BOARD MEMBERS WILL BE HELD HARMLESS IN ANY AND ALL ACTIONS THAT ARE INVOLVED WITH THE LOCAL, STATE, & NATIONAL PAGEANT.
I AGREE:
Applicant Signature: ______________________________________________
Parent SIgnature: _________________________________________________
(If applicant is under 21 years of age)
Date: _______________________
There are NO refunds on registration, entry fees, misc. services and/or items purchased at the pageant!
The Executive State/National Director has the right to change pageant dates and times from the original date, also the Executive State/National Director has the right to change the format, set-up, line-up, dis-qualification of contestants & winners and the content of gifts and prizes. You will be notified in advance if the date of the pageant changes. If your child is sick and can not attend the scheduled pageant then he/she can participate in the next scheduled pageant.