Scholarship Pageant

Contestant's Name *

First Name

Last Name

Birthdate *

MM

DD

YYYY

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Resident of Page

You must be a Page County resident to compete in the Jr., Miss, and Mrs. categories. By checking this box, I certify that the Contestant is a Page County resident. I understand that no refunds will be issued for not meeting residency requirements.

Page County Resident

NON-PAGE COUNTY RESIDENT

Parent / Guardian Name

First Name

Last Name

Phone *

(###)

###

####

Digital Consent *

Participant further agrees to abide by all rules and regulations as set forth by the Page Valley Fair Association; failure to do so will result in disqualification. I also agree that my image and/or name may be used for future Page Valley Fair and/or pageant events. If the participant is under 18 years of age, parent or guardian must sign. My signature below acknowledges that I have read the rules and regulations and agree to adhere to them.

By checking this box, I have read and agree with the above statement