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2021 National American Miss State Pageant Application For Florida, Texas, Oregon, & Washington

Welcome to the National American Miss State Pageant Registration Form for Florida, Texas, Oregon, & Washington. If you plan to compete in your upcoming State Pageant, and have not already completed this form, please do so now.

If you are under 18 years old, please have a parent or guardian register for you.

Your NAMily can't wait to see you!

If you have any questions please reach out to one of our pageant representatives at 281-496-9000

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State Pageant:*
Select the state pageant that you will be competing in this year. Remember, you must go to school or reside in the the state in which you will be competing. If you do not reside in one of the listed states, please click here to find your state and contact your state director to apply.

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Contestant's Name:*
First Last
Address:*
Street Address Address Line 2 City State ZIP Code
Best Phone Number For Contact:*
Parent's Cell Phone:
Contestant's Cell Phone:
Age as of January 1st in this year of competition:*
How old was the contestant on January 1st of this year?
Your Birthday*
Date Format: MM slash DD slash YYYY
Parent or Guardian Name:*
First Last
Additional Parent or Guardian Name:
First Last
Email:*

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Select A Promotion*
- TOTAL SAVINGS: $120 When you register now and pay $100 toward the standard sponsorship fee of $550. The registration fee of $20 will be waived. The $550 sponsorship fee will be discounted by $100 and your sponsorship balance will be divided into two payments.
- TOTAL SAVINGS: $70 When you register now and pay $50 toward the standard sponsorship fee of $550. The registration fee of $20 will be waived. The $550 sponsorship fee will be discounted by $50 and your sponsorship balance will be divided into two payments.
- Register now by paying only the standard $20 Registration fee. The $550 pageant sponsorship fee will be divided into two payments.
Total
$0.00

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Acknowledgements:
By answering "I Agree" to each of the following statements and clicking the "Submit" button below you acknowledge the following:
I understand that the State Yearbook deadline and all materials I want to be included in the Yearbook must be in the pageant office at least three weeks prior to the first day of this year's state pageant. This includes photos, sponsor names, Spotlight Contest pages, and the payments associated with these items.*
I understand that I am responsible for my own travel and lodging reservations and any expenses at the statae pageant. If I earned and chose the Free Hotel Night through the Spotlight Contest, then I will receive the appropriate reimbursement based on the award. (Please see the Spotlight Magazine for more information.)*
I understand that I may complete Spotlight Contest pages for the State Yearbook to earn prizes such as hotel room nights (contestant must make their own reservation), sponsorship fees to the National All-American Queen’s competition, entry into the major optional contests, tickets for Disneyland®, a trip to the national pageant, the National Ambassador Title, National Cover Girl Title, the National Cover Model Title, the National Cover Miss Title, State Cover Girl Title, and more!*
The contestant named on this form must reside or go to school in the state she represents, and she must participate in her correct age group. Neither the contestant, nor any of her immediate family members are employed by National American Miss, Inc. or National American Miss. In consideration for being accepted as a contestant in the national pageant activities, we, the parents and/or guardians of the contestant, do hereby release National American Miss, Inc., National American Miss, its staff, directors, subsidiaries, parent companies, assignees, employees, and volunteers from any and all claims and damages directly or indirectly resulting from named contestant participating in the National American Miss events; and we give permission to National American Miss, Inc. and National American Miss to use the contestant’s photographs, speeches, Community Service entries, testimonials, videos, etc., for publicity purposes and future material in printed, video, and/or internet form. It is agreed and understood that any scholarships, prizes, or college allowances that are part of the state and national programs are provided by the named sponsor, school, business, agency, or college, and that National American Miss, Inc. and National American Miss shall have no liability in regard to such scholarships, prizes, or college allowances. It is understood that all state and national pageant fees are non-refundable without exception. Contestant must not be married nor ever have been married.**

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Would you like to make an additional payment?*
- Yes
- No
If you would like to make an additional payment for Optional Contests, Tickets, Production Number Outfit, etc.
Additional Payment Amount:*

If you would like to make an additional payment you may enter the amount here.
List What This Additional Payment Is For:*
Total
$0.00

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Payment Method*
- Credit Card
- Paypal
Total
$0.00
Credit Card Information:*

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name

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COVID-19 Waiver

Click here for Florida | Click here for Texas

2021 National American Miss State Pageant Application For Florida, Texas, Oregon, & Washington

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Acknowledgements: