Miss Northern Suburbs Princess Enrollment Form

Miss Northern Suburbs Princess Enrollment Form
Princess Name *

First Name Last Name
Returning Princess? *

Yes No

Address *

Street Address
Street Address Line 2
City	State
Zip Code	Country

Phone Number *

Area Code Phone Number
Date of Birth *

Month Day Year Date Picker Icon
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. *
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 princess on stage. MC has the right to edit introduction for time constraints. *
There is a $350 entry fee to participate in the Miss Illinois Princess Program in which Miss Northern Suburbs is not responsible. *

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

Rules of Conduct for Miss Northern Suburbs Princess

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

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

A Princess 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 MISS NORTHERN SUBURBS PRINCESS” AND AGREE TO FOLLOW *

Yes No
Miss Northern Suburbs Princess 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 Miss Northern Suburbs Princess Mentoring Program, with rehearsals. The Miss Northern Suburbs Princess 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 Princess 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 Princess 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" *

Yes No
Date Submitted *

Month Day Year Date Picker Icon
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.
Princess Name *

First Name Last Name
Parent/Guardian's Signature *

Clear
Parent/Guardian's Signature *
Form Submitted By *
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