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2010 National On-Line Entry Form


A $200 deposit must accompany all entries. No Checks accepted!
Any Questions call (276) 646-5602
Mail to: Shelia Call *255 Middle Fork Road* Marion, VA 24354
No Door Entries will be accepted! The line-up for each age division is determined by the date your
entry, deposit and photo for the calendar is received


(*Note* - Deposit, Entry Form and Photo is required to be placed in line-up)
First in, last out or your choice. We honor request for line-up on a first come, first serve basis.
Submit a wallet size photo for the calendar. You may send your photo by mail or by e-mail in JPG format.
Deadline to submit photos for the calendar is October 20th.
 


Early Bird Package Deal -............................................................................................................
(Enter on or before July 30th)
(Includes registration fee, supreme package and all optional events on the form. Does not include the calendar cover contest, sweatshirt, and door badges. No other discounts won will apply)		 $695



Second Chance Package Deal - .....................................................................................................
(Enter on or before Sept 15th)
Includes registration fee, supreme package and all optional events on the form. Does not include the calendar cover contest, sweatshirt, and door badges. No other discounts won will apply) 		$795


 


 
Last Chance Package Deal - (Enter on or before November 1st )..........................................................
(Includes registration fee, supreme package and all optional events on the form. Does not include the calendar cover contest, sweatshirt, and door badges. No other discounts won will apply)		 $875

 

 
Supreme Package. (Includes the Ultimate Grand Supreme, Grand Supreme, Age Division Supreme, National Beauty, Division Face Queen, Christmas Casual Wear, and 1 B/W Photogenic. If deposit is postmarked or received by October 5, 2010...................................... $395

 

 
Supreme Package. If deposit is postmarked or received by October 20, 2010. $475 after October 20th.................................. $445
 
Mandatory Registration Fee .This fee includes your photo in our National Calendar, one copy of the calendar and 1 door badge............ $225
 
Sweatshirt (needed for crowning)

Youth Size None 2-4 6-8 10-12 14-16
Adult Size None S M L XL XXL

$30

 

 
Line-up request & Date entered: _______: #
 

~Optional Events~
(Not included in the Supreme Package and not required to enter) (Check which one(s) you will be entering)
Level Supreme ................................... $95
Outfit of Choice............................. $95
Side Awards: Most Gorgeous Dress, Smile and Hair.......................... $55
Color Photogenic........................................................................... $85
Natural Photogenic..................................... $85
Composite......................................................... $85
Print Model........................................................ $85
Gorgeous Girl Face Supreme................................................... $95
Sub Total............................................................................................................................... $
Less any Certificates (fees won) List which state, photo contest or other discount that was won.
Cannot be combined, highest amount may be used................		 -$
Less $200 deposit * No Checks Accepted* Money Order or Cashier's Check only
(Any certificate (fees won) cannot be used as your required deposit).................................		 -$
Balance due at registration (Cash only) No PayPal accepted after November 10, 2010............................  $


Contestant's Name:   Age Division:    Date of Birth:


Address: City:


State:    Zip:   Phone Number:


Parents: Referred By:


Email:
                                                                                 

Payment Method PayPal Money Order Cash

I have read and understand all rules and regulations. I release AGG, Shelia Call, staff and event location from all liability from any injury, loss or illness that may occur at, or to/from the pageant. No refunds or transfer of fees paid. I have provided all true and correct information. Should age or level status be found untrue, I will be responsible for returning all awards and /or paying court fees should legal action be necessary. I give my permission for any photos or videos of my child to be used in future promotional advertising. All judges’ decisions are final! Poor sportsmanship will not be tolerated. I can be disqualified with no refund at the Director’s discretion.


Parent's Signature: Date:

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