AMERICA'S REGAL GEMS

AMERICA'S REGAL GEMS MASTER APPLICATION

CONTESTANT NAME ___________________________________________________
ADDRESS  ___________________________________________________________  
CITY/TOWN       ZIP ____________________________________________________
PHONE _______________________         E-MAIL ____________________________
D.O.B.  ______________________

AGE DIVISION (CHECK ONE) Age as of date of pageant with 60 day grace period

  ___   0 - 3 YR    ___   4 - 8 YR   ___   9 & UP

SAVE SAVE SAVE

____   ENTER  AMERICA'S REGAL GEMS BY February 1, 2009  $550 (receive all all events, registration fee and  entry into ARG Amethyst Supreme)  Total savings $220


___  $395 SUPREME PACKAGE    (Beauty and 3 events)   
  

CHECK 3 EVENTS ENTERING
____ Model    ____  Fashion    ____  Swimwear    ____  Glitz Photogenic   
    ____ Natural Photogenic    ____  Composite    ____  Portfolio    ____Talent

_____  BEAUTY  (Mandatory)         $275

ADDITIONAL EVENTS    $50 EACH (enter by February 15, 2009 take 2 optionals FREE)
 
____ Model    ____  Fashion    ____  Swimwear    ____  Glitz Photogenic   
    ____ Natural Photogenic    ____  Composite    ____  Portfolio    ____Talent

  
ADDITIONAL GLITZ PHOTOGENIC                                         _____  @  $10
ADDITIONAL NATURAL PHOTOGENIC                                 _____  @  $10
ADDITIONAL COMPOSITE                                                     _____  @  $10
ADDITIONAL PORTFOLIO                                                      _____  @  $10
ADDITIONAL TALENT  (One only)                                                                     $25 
         AD PAGES  SOLD  ____ @       $50 each  $ ________
         (Ad pages must be paid in full by March 1, 2009 to receive credit)
        
 
        REGISTRATION FEE     (Mandatory)    $125
         (Includes  program book picture, 1 program book and 1 admission ticket )


ADMISSION TICKETS SOLD AT DOOR: Adults $15, children under 12- $10.

                                                      SUBTOTAL   $________


Referral,  Sibling Discounts or Preliminary Credits  $________
(You may take highest credit earned only)

Ad Page Credit  ____ @ $25 each $_______

                                              
 All applications received by February 15, 2009 will have special entry into Amethyst Supreme for
a special gift.  
(highest combined score Beauty and either model or fashion)


                                                                   TOTAL CREDIT  $________

LATE FEE   $50   $________
(If applications received after TBA)

                                                                                  TOTAL   $________
DEPOSIT     $150   $________
(Non-refundable minimum of $150.00. Check, Money order or Paypal accepted.  A $25 fee will be charged for any returned checks.)


BALANCE DUE AT REGISTRATION $________
(CASH ONLY AT REGISTRATION)

IF STAYING AT THE HOTEL  _____  NO. OF NIGHTS   _____ NO. OF ROOMS
REFERRED BY ______________________________
LINE UP PREFERENCE  _____  FIRST     _____  MIDDLE      _____  LAST

NUMBER OF YEARS COMPETED AT ARG  _____
ENTERING MOM PAGEANT  ___      ENTERING DAD PAGEANT ___

America's Regal Gems, the hotel and any of our affiliates are NOT responsible for any injuries or losses incurred during or traveling
to or from our events. All judges decisions are FINAL. Contestants and their families WILL conduct themselves in a mannerly fashion
at all times. Displays of poor sportsmanship will NOT be tolerated and may result in disqualification of contestant.
Entry fees are NON-REFUNDABLE.  By signing this application you give America's Regal Gems the right to use your name and
pictures for publicity purposes.  You also attest that the above information is true and that you understand the rules and regulations
and you will comply with them.

        _____________________________________________           __________________
      Contestant's signature Parent or Guardian if minor)                      Date

Mail application and Deposit by March 1, 2009 to:

America's Regal Gems
41 Pleasant St.
Somerset, Ma. 02726-4119                                     Go back