CCs Beauty Pageant Registration Form

CC's Beauty Pageant Registration Form
Mark Pageants You Wish to Compete In
Total $
Child Information
Full Name

First NameLast Name
Age Group
Birth Date

MonthDayYear
Eye Color
Hair Color
Gender
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
Guardian Name
WAIVER, RELEASE AND ASSUMPTION OF RISK:

I assume all risk individually and on behalf of my guests, invitees, minors in my company and/or authority. Furthermore I/We hold harmless; Ceila Walker, Super Flea, its owners, employees, vendors, sponors, corporations, partners, subsidiaries, volunteer's, advertisers, and all its agents from litigation, judgment, attorney fees, loss liability, injuries, medical treatment, damage, penalties or cost that may occur as result of my participation in said event. I agree to release all right to claim financial or reimbursement for any photos that may be used for promotional purposes only.
Signature of Participant/Guardian
Date
By signing below you agree to have full consent and authority to sign on behalf of said minor:
Minor Name
Relationship to Minor
Should be Empty:

CC's Beauty Pageant Registration Form