APPLICATION CAN BE EMAILED TO DAWNDHOLLAND@AOL.COM OR SENT VIA POSTAL MAIL TO 2643 MISTY ROCK COVE, DACULA GA 30019
___ Tiny 3-4 ___Petite 5-6 ___Little 7-8
___Young 9-10 ___ Pre-Teen 11-12
_____Junior Teen 13-14 ____Teen 15-16 ___Miss 17-18
________Elite Miss 19-21 (must be currently enrolled in University/Tech School)
______Mrs 22 + Married ____ Senior Ms 55+
Contestant Name ___________________________________________________________
Age _____
Date of Birth_________
Age day of Pageant (this is the category you will compete in)________
STUDENT EMAIL(optional) (For updates regarding pageant) _____________________________
Parents Names: ___________________________________________________________
PARENT EMAIL(Required for updates regarding pageant) ______________________________
Address ______________________________________
City__________________________ County_____________________ Zip______________
Phone __________________________
Another Contact Number ______________________
School _______________________________________
Grade/Major ________________________
Hair Color ______________________________
Eye Color ___________________________
Honors/Awards_____________________________________________________________
____________________________________________________________________________
Activities/Interests ___________________________________________________________
_____________________________________________________________________________
Future Plans __________________________________________________________________
_____________________________________________________________________________
Favorite Food ____________________________
Favorite Color _______________________
Sponsor(s): ____________________________________________________________________
Favorite Past Time _____________________________________________________________
In honor/memory of ________________________________________________________________________
I certify that I have been given a copy of the Pageant Rules and will conduct myself in a sportsman like manner. I accept the judge’s decision as final and will not dispute them. Both the parent(s) and the contestant both understand that proper behavior will be expected, should it not be, and then it will disqualify the contestant from further participation in Miss Georgia Relay for Life. All winners understand that while making public appearances, the Director, has at her discretion to remove you from the event if improper behavior is observed and could ultimately result in removing the title from the winner. The winning queen may only participate in the next years pageant by crowning her successor. Once she reaches the next age division she is available for, example, if a contestant wins “Tiny Miss” are age 3, she would then crown her successor the next year (should possibly have turned 4 and can then complete again in the 5-6 age division. Girls can only hold 1 title once in a life time. You cannot be Miss Georgia Relay for Life more than once in your lifetime.
Signature of contestant or parent _____________________________________________________________________
Parent Signature if minor _________________________________________________________________________________
Contestant Emcee Card
Age Division: ________________________Contestant # _____
Now taking the stage is (name) ___________________________ and today she is competing in the _____________Georgia Relay for Life division.
Fill in division title competing in
She is (age) ____________ years old
from (city/state) ___________________________.
(name)________ is a student at (school) ____________________.
Only if applicable, if not put N/A Only if applicable, if not put N/A
She has (hair color) __________ hair and (eye color) __________eyes.
Her favorite food is ______________________________.
Her favorite hobbies include ___________________ and
____________________________.
Her family and friends say that _______________,
_______________, and _______________ are 3 words
that describes her best.
She feels that her best quality is_________________________.
Her future plans are to become a/an ________________________.
She is sponsored today by: ________________________
_______________________________________________
_______________________________________________.
Ladies and Gentlemen this is (name) _______________________
Contestant # _______________
Contest # to be filled in by Pageant Staff