Princess Permission Form Due: Tuesday, MAY 5, 2009

Please Print Clearly Contestant’s Name: ______Date of Birth: ______

Club Name: ______

Contestant’s Address: ______

City: ______State: ______Zip Code: ______

Contestant’s Area Code & Home Phone Number: ( )______

Contestant’s Area Code & Cell Phone Number: ( )______

Contestant’s E-mail Address: ______************************************************************************************* Contestant’s Parent or Guardian’s Signature We give permission to the (insert club/association name) ______and the Delaware River Yachtsmen’s League and their designees to use the contestants name and photograph for publicity in connection with representing the (insert club/association name) ______in the Delaware River Yachtsmen’s League Queen’s Pageant in 2009. We also agree that the above organization is not responsible for lost or damaged personal property at any given time.

______Contestant’s Signature Date

______Parent or Guardian’s Signature Date

************************************************************************ Commodore or President’s Signature We give permission to the Delaware River Yachtsmen’s League to enter our princess, representing the (insert club/association name) ______and we agree to enter and participate in the contest for Miss DRYL Queen in accordance with the rules.

______Name of Club or Association

______Print Commodore or President’s Name Signature of Commodore or President’s Name Date

Please submit completed application with $150.00 application fee that will include 1 full page in 2009 Program Book. Please Return To: Toni Nespola 6340 Militia Court, Bensalem, Pa 19020 215-741-9711 * [email protected]