Little Miss Northern Suburbs Enrollment Form

Little Miss Northern Suburbs Enrollment Form
Little Miss Northern Suburbs Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*

Area CodePhone Number
Date of Birth*

MonthDayYear
Parent/Guardian Names*
Parent/Guardian Email*
Where all princess program information will be sent.
Headshot photo to be used in program book. Must be jpeg format.*

Upload a File

Cancelof
Are you a returning Little Miss Northern Suburbs?

YesNo
Sash Size
T-Shirt Size
Please list any allergies (food, medications, etc.)*
Any other medical conditions we should be aware of?*
Please provide an introduction statement that will be used to announce Little Miss Northern Suburbs on stage. MC has the right to edit introduction for time constraints.*
There is a $400 entry fee to participate in the Miss Illinois Little Sister Chapter, Miss Illinois' Jewels, in which Miss Northern Suburbs is not responsible.*

My daughter would like to participateMy daughter would NOT like to participate

Rules of Conduct for Little Miss Northern Suburbs

The Rules of Conduct for Little Miss Northern Suburbs are the foundation upon which the images and reputation of the Miss Northern Suburbs Little Sister Local Chapter is being built and will continue to be the basis for its operation. Little Miss Northern Suburbs will conduct themselves at all times with dignity, grace, and good manners of young women who exemplify the integrity of American youth. Little Miss Northern Suburbs must observe all rules and regulations.

Little Miss Northern Suburbs will not participate in any interview, picture, press contact or any types of publicity unless a member of the Miss Northern Suburbs Committee is present.

Little Miss Northern Suburbs will not attend parties, meetings, and social events or make any public appearances other than at regularly scheduled events of Miss Northern Suburbs.
I HAVE READ THE ABOVE “RULES OF CONDUCT FOR LITTLE MISS NORTHERN SUBURBS” AND AGREE TO FOLLOW*

YesNo
Little Miss Northern Suburbs Publicity Release*

I HEREBY GIVE the Miss Northern Suburbs Organization permission to use my daughter's name and picture(s) for publicity in newspapers, pamphlets, web pages, TV and radio.
Hold Harmless Agreement

I acknowledge her application to participate in the Little Miss Northern Suburbs Program, with rehearsals. The Little Miss Northern Suburbs hereby agrees to indemnify and hold harmless the Miss Northern Suburbs program, the Board and any other entities, which might be construed as liable from and against any and all claims for personal injuries, death, damages, cost and/or other expenses including reasonable attorney’s fees arising from or in any way connected with the use of the premises, and Little Miss Northern Suburbs does hereby waive any right of recovery against the Miss Northern Suburbs program, the Board and any other entities which might be constructed as being responsible for loss, damage, theft of such equipment, stock-in-trade, personal property, etc. This agreement is subject to termination by the Miss Northern Suburbs program, without advance notice or penalty at any time. This agreement is personal to the Little Miss Northern Suburbs and may not be transferred or assigned.

In witness whereof, this agreement has been executed as of the date indicated below.
I HAVE READ AND ACKNOWLEDGE THE ABOVE "HOLD HARMLESS AGREEMENT"*

YesNo
Covid-19 Release

I acknowledge and agree that by participating in the Little Miss Northern Suburbs Program, I shall assume my own and my daughter's risk of liability against Covid-19 or its mutations and shall indemnify and release any claims against the Miss Northern Suburbs Organization.
I HAVE READ AND ACKNOWLEDGE THE ABOVE "COVID-19 RELEASE"

YesNo
Date Submitted*

MonthDayYear
I hereby acknowledge that I am complying by the rules and regulations of this program and all the facts contained herein on this enrollment form are true and accurate. I understand that my application fee is non-refundable for any reason nor is this application transferable.
Little Miss Northern Suburbs Name*

First NameLast Name
Parent/Guardian's Signature*

Clear
Parent/Guardian's Signature*
Form Submitted By*
Little Miss Northern Suburbs Participation Fee

PAY HERE
Should be Empty: