Miss Middlesboro and Little Miss Middlesboro 2014

Bring Back The Magic!!!

Presented by MHS Football Boosters Club

Pageant Date: Saturday, April 19th

Place: Middlesboro High School Gymnasium
Time: 6:00 pm
Entry Deadline: Thursday, April 7th
Entry Fee: $35.00

Check or money order only

Photogenic (optional): $15.00

Please submit a 5x7 or 8x10 with application

Age Divisions
1-3 years

Wee Miss

4-6 years

Tiny Miss

7-10 years

Little Miss

11-13 years

Jr. Miss

14-18 years

Miss

Each contestant will be assigned to the appropriate age division

according to the contestants age on day of pageant

Applications Pickup and Drop off Points:

Middlesboro High School, Signatures Hair Salon, Signatures Formal Boutique,
Middlesboro ARH Gift Shop
Please make checks payable to Middlesboro Varsity Football Boosters Club

Miss Middlesboro and Little Miss Middlesboro 2014

Registration Form
Name:_____________________________________________________________
Address:____________________________________________________________
Phone:_____________________________________________________________
Parents: ___________________________________________________________
Age:________________
Brothers/Sisters:_____________________________________________________
Grade:_____________________School:__________________________________
Hair Color:__________________Eye Color:________________________________
Favorite Color:_______________Favorite Food:____________________________
Favorite T.V. Show/Movie:_____________________________________________
ExtraCurricular Activities/Hobbies:_______________________________________
___________________________________________________________________
___________________________________________________________________
Awards and Honors:__________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

Goals/Future Plans:___________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

Rules and Regulations:

Parents of contestants must read the following information and sign for official application to
be considered. Parents/Guardians must be able to provide proof of residency
Contestants must have a current address within Middlesboro City Limits and/or attend
Middlesboro City School, Gateway or St. Julians
Contestants must compete within their correct age group. Applicants 19yrs old who are still
currently enrolled in high school ARE eligible
Applicants must have never been married or have a child
Formal Wear Only all age divisions
Miss Middlesboro contestants will be asked a question about current events or our community
Mandatory rehearsal Friday, April 18th
Waiver and Release of Liability
I acknowledge and assume the risks of participating in The Miss Middlesboro Pageant. I waive,
release and discharge from any and all claims or liabilities for death personal injury or damages
of any kind. I agree not to sue any persons or entities involved with the pageant for any of the
claims or liabilities that I have waived, released or discharged.
My signature certifies that I have read and I understand the information above, and I am
eighteen (18) years of age.
_____________________ ___________________________
Printed Name

Participants Signature

____________
Date

If under the age of eighteen:

I am the parent or legal guardian of the minor named, and I execute the foregoing Waiver and
Release on behalf of them. I confirm that I have the legal authority to act for and on behalf of
the minor named herein.
_____________________ ____________________________

_____________

Printed Name

Date

Parent/Guardians Signature

For any additional information please visit our Facebook page at Miss Middlesboro Pageant 2014