Placer Valley Application

Pageant Date/Time

Date: August 7, 2021
Wee Miss/Little Miss/Pre Teen/Jr Teen Pageant: 11:00am
Teen/Miss/Ms/Mrs Pageant: 4:00pm
*Times subject to change

Additional Pageant Information

2021 Placer Valley Pageant Application

* Indicates required field

Choose Your Age Division *

Wee Miss (4-6 yrs) $120.00 Little Miss (7-9 yrs) $120.00 Pre Teen (10-12 yrs) $160.00 Jr. Teen (13-15 yrs) $160.00 Miss Teen (16-19 yrs) $200.00 Miss (20-29 yrs) $250.00 Ms (20 and up) $160.00 Mrs (married) $160.00

*Entry fee includes entry for all categories and awards. Fee for Wee, Little, Pre Teen and Jr Teen includes the Fitness Wear tank top. Fee for Teen, Miss, Ms, & Mrs includes Fitness Wear leggings and choice of tank top or sports bra.

*Note age divisions may be combined or split depending on final number of contestants

Contestant Name *

First

Last

Parent Name (if under 18 yrs old) *

First

Last

Phone Number *

Email (this is how you will receive confirmation) *

Contestant's Date of Birth *

Address *

Line 1

Line 2

City

State

Zip Code

Country

3 Things About You *

How Did You Hear About Us? *

Promo/Discount Code *

Submit