Miss

Select an Age Range*

17-22

Contestant Full Name*

First NameMiddle NameLast Name

Age as of August 24th, 2019*

Date of Birth*

Parent's Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Area CodePhone Number

Email*

example@example.com

Sponsored By:

Grade

Hair Color

Eye Color

School/Graduation Date

College Attending

Class Year as of 1/1/2019

Honorary Sorority

Social Sorority

Scholarship Information: Please state how you would use any scholarship monies you may receive from the pageant, the college degrees you are seeking, and/or the special training degree you desire.

Briefly describe yourself in 25 words or less

High School Honors

College Honors

Accomplishments obtained with any civic organization, church, religious groups, etc.

How are you involved with the 2019 Floyd Livestock and County Fair?

Hobbies

Employment History

Interesting facts about yourself or your family

Career Ambition

Please complete this line: In her spare time (your name)

Platform Title

Give a brief overview of your platform

1. Contestants must live in Floyd County or surrounding area and be of or between the following ages at the time of her local crowning: 17-22

2. Contestant must possess good moral character having never, at any time, been convicted of any crime nor have any criminal charges against her. Also must never have committed an act or engaged in any activity which is or could be characterized as dishonest, immoral, indecent, or in bad taste. This INCLUDES texting, use of the internet and all social media.

3. The pageant will be Saturday, August 24, 2019; exact times to be determined by participation. Please arrive early and be ready for the pageant to start. If you are unable to attend or will be late, please contact the director.

4. All pageants will be held at Barn Facility at Chantilly Farm, 2697 Franklin Pike SE, Floyd, VA 24091

5. Entry fee is $60.00

6.Entry fee includes one adult admission. Additional tickets can be purchased at the door.

7. Mail applications and entry fee to FLOYD FUTURE P.O. Box 179 Floyd, VA 24091

*If entry fee is not submitted with application, we may invoice you via email using our online payment system.

8. All applications and payments must be received by August 20, 2019.

9. Contestants should practice competing in evening gown, casual wear, interview, onstage question, platform speech and photogenic. Contestants and those accompanying contestant shall conduct themselves in a proper manner at ALL times or be disqualified.

10. All judges’ decisions are FINAL.

The Floyd Livestock and County Fair and all of its agents cannot be held responsible for accidents, injury, or loss of personal property related to this event. I have read the entry form and agree to abide by the pageant rules. Failure to do so may result in disqualification.

Parent/Guardian Signature (if a minor)*

MEDIA RELEASE FORM: I hereby give my consent for The Floyd Livestock and County Fairs’ use of images, voice or likeness from videotapes, photographs, motion picture film, electronic images and/or other technologies in which I and/or my minor child appear. Furthermore, I hereby consent that such photographs, films, recordings, electronic images and the film, slides, disks, plates, or tapes from which they are made shall be their property and for appropriate organizational uses, including internet use.

I have read the Entry Form and Media Release Form, and agree to abide by the Pageant Rules*

Miss

Rules, Regulations, Media Release