Little Miss & Mr. Lago Vista Pageant Entry Form

Please enter the information for your pageant entry into the form below and click on the Submit Entry Form button to submit your entry.

After you have filled in the form and clicked on the Submit Entry Form button, a summary of the information you entered will appear. In order to complete your registration, please print two copies of this entry. Keep one for your records and please mail the other to:

Judy Geddes
PO Box 5338
Jonestown, TX 78645

in order to complete your registration.

* indicates a required field. You must fill in all required fields in order for your entry form to be accepted.

First Name:* Last Name:*
Street Address:* City:*
State:* Zip Code:*
Phone Number:* Emergency Phone Number:*
E-Mail:
(Please see note (1) below)
Grade in School:*
(Please see note (2) below)
Birthdate:*
(Please see note (3) below)
Gender:*
Responsible Adult*:
Will the Entrant be Performing?:*
(Please see note (4) below)
Performance Information:
Master of Ceremonies Info:
(Please see note (5) below)
Comments:
(1) Please enter an e-mail address if possible. If you specify an e-mail address, a copy of your entry form will be sent to the e-mail address you provide. You will also receive e-mail confirmation of your entry as well as further details regarding the pageant within five days of the receipt of your completed entry form.
(2) Please select the school grade the entrant will be in during the 2007/2008 school year.
(3) Participation in the Little Miss & Mr. Lago Vista Pageant is limited to children eight years of age or younger as of July 4, 2008.
(4) Please indicate whether the entrant will be performing. If the entrant will perform, please describe the type of performance (music, dance, etc.) and provide details of the performance in the Performance Info box. Please note that all performances will be limited to three minutes so that all entrants will have an opportunity to perform if they wish. A CD player will be available at the pageant if the entrant requires music for his or her performance.
(5) Please provide any information about the entrant that you would like to have mentioned by the pageant master of ceremonies.
Release from Liability and Indemnification
We wish to participate in the Little Miss & Mr. Lago Vista Pageant. We, individual(s) or organization, Indemnify and Hold Harmless the Lago Vista 4th of July Council, its Volunteers, the City of Lago Vista from any and all claims, suits, losses, damages, expenses on account of the Little Miss & Mr. Lago Vista Pageant. Further, the noted individual(s) or organization will defend the Lago Vista 4th of July and the City of Lago Vista, and its agents from all claims or bodily injury or property damage arising from their participation in the Little Miss & Mr. Lago Vista Pageant. We understand that we are responsible for our own safely and actions. By checking the box below, I, the individual named in the First Name and Last Name boxes above, signify that I have read this Agreement and understand and agree to all its terms.
I have read the above Release from Liability and Indemnification
agreement and understand and agree to all its terms.
I agree