ULTIMATE DREAM QUEEN GRAND NATIONALS OFFICIAL ENTRY FORM

ULTIMATE DREAM FACE GRAND NATIONALS

NAME__________________________________DOB____________AGE GROUP_________

ADDRESS______________________________________________________________

CITY_______________________________STATE________ZIP_________________

HOME PHONE NUMBER_________________EMAIL___________________________

SS #_____________________________________REF BY________________________

 FAVORITE COLOR_______________________FAVORITE FOOD________________

BEST FRIEND___________________________AMBITION____________________

SPONSORS_____________________________________________________________

I hereby give my authorization and permission for any photos, videos or other publicity pertaining to my self/child to be released for newspaper, magazine and internet. I waive any and all claims for any nature hereafter acquired against Ultimate Dream Queen, Edie Klein, Donald Klein and staff, volunteers, contestants, hotel, or any other facility workers for any damages, injuries suffered or death, during the time myself, child or my guests are participating in the pageant or related activities. I affirm that all information enclosed is true. I understand that the judges decisions are final, and there is to be no approaching or talking to the judges anytime during or after the competitions. Any display of poor sportsmanship will result in immediate disqualification from Ultimate Dream Queen Pageants. I understand that all fees are non refundable in the event I cannot attend the pageant for any reason, including my child/children become ill or in the event the pageant is canceled or rescheduled or you or unsatisfied with the outcome of the pageant or disqualified. If pageant is cancelled you will receive credit towards the next pageant...

Signed on the ___________________Month__________,Year__________By:_________________

*********************************************************************

(Proof of age is required) Copy of birth cert or Baptismal Cert

TALENT 3.0 Minute Time Limit all tapes or CD must be cued

1. ___________________________________________________________

2.____________________________________________________________

 ***********************************************************************

MODELING 2 1/2 Minute time limit - MR TIM WILL PROVIDE THE MUSIC

1.__________________________________________________________________

2.__________________________________________________________________

Top of Form

No entry will be processed unless it is paid by Paypal or money order

Bottom of Form

You may also mail your forms to:
Edie Klein
11087 Malone St.
Rancho Cucamonga, CA 91701