<p> State Entry Form</p><p>Name ______Age ______B/D ______Phone(A/C) ______(Age Date of Pageant) Mailing Address ______City ______State ____ Zip______Email Address if available : </p><p>Check division you are Entering:</p><p>_____ TINY MISS (2-3) _____ JUNIOR MISS (7-9) _____ TEEN MISS (13-15) _____ PETITE MISS (4-6) _____ YOUNG MISS (10-12) _____ ELEGANT MISS (16-19)</p><p>Items with ‘X’ are Mandatory:</p><p>$_____ Modeling Entry Fee - $75.00. Entry Fee is paid if you are a preliminary Modeling Winner. Runners up may deduct $50.00. $_____ Talent Entry Fee - $75.00. Entry Fee is paid if you are a preliminary Talent Winner. Runners-up in Talent may deduct $50.00. $_____ Glamour Girl (Optional) - Entry Fee - $50.00 (Paid if Preliminary Winner).</p><p>$_____ GRAND TALENT (OPTIONAL) - Entry Fee - $25.00 $_____ SUPREME MODEL (OPTIONAL) - Entry Fee - $25.00 </p><p>$_____ (X) You must pay for your photo in the Program Book! (Please mail a picture with entry). Choose from 2 options below - Please mark your choice: (1) ½ page in the book - $100 includes photogenic - May list 5 Sponsors _____ (2) Full page in book - $135 - includes photogenic - May list 10 Sponsors _____ (3) Full page for 2 in a family – $150 – includes photogenic – May list 5 sponsors _____</p><p>$_____ (X) You are required to wear the NEW! “OUR DIAMOND MISS” T-Shirt for interview. T-Shirts are $15.00 each. Please circle size and quantity:</p><p>Children: X-Small(4) Small(6-8); Medium(10-12); Large(14-16) Adult: ___ Small; Medium; Large; Extra-Large</p><p>$ (X) Mandatory Base Fee (Program book, registration fee, etc.) (1) One contestant in a family - $75 (2) Two contestants in a family - $100 </p><p>$_____ (X) Admission Badges - $20.00 each. Buy badges and save $ OR pay at the door. Quantity: ____</p><p>$_____ (X) Awards Breakfast Tickets are $13.00 each (Contestants will need a ticket if they attend.) Quantity needed: ______.</p><p>$_____ DIAMOND GIRL - Optional - Entry Fee $75.00 for all 5 events or $20.00 per event.</p><p>$_____ Extra Photogenic Pictures @ $20.00 each – Optional</p><p>$_____ Portfolio - $25.00 – Optional $_____ TOTAL AMOUNT DUE  CASH OR CERTIFIED FUNDS ONLY  $_____ AMOUNT ENCLOSED  SPONSOR CHECKS MUST BE RECEIVED BY DEADLINE $_____ BALANCE DUE  DEADLINE TO ENTER IS MAY 10, 2007</p><p>I do hereby give my child permission to enter ODM Pageants. I agree to abide by the rules and regulations and understand that actions to the contrary could result in disbarment and forfeitures of all fees and titles by sole discretion of the sponsor. I agree to hold harmless the Staff of Our Diamond Miss from liabilities due to theft, accident or injury while participating in or having to do with Our Diamond Miss Pageants.</p><p>SIGNED (Parent or Guardian) Date (over) Master of Ceremonies </p><p>Division ______Number ______</p><p>Please Print Clearly:</p><p>Name Age Date of Pageant Parents or Guardian</p><p>Address City State Zip</p><p>Sponsors: </p><p>(Please PRINT all sponsors’ names clearly as you would like them to appear in the program book - these can also be submitted on a separate sheet of paper to insure correct spelling and listings)</p><p>Professional Training: (Teachers, Coaches or School)</p><p>Tap </p><p>Ballet </p><p>Vocal </p><p>Jazz </p><p>Gymnastics </p><p>Modeling </p><p>Drama and/or Monologue </p><p>Other </p><p>Favorite Hobby </p><p>Ambition </p><p>Favorite Interest </p><p>List Awards You have Won (Other than pageants) </p><p>Name of Talent: </p><p>Type of Talent (song, dance, etc.): </p><p>Circle type of microphone you need, if any: Cordless Mic Head Mic No Mic Corded Mic Mic on a Stand</p>