NES PENNSYLVANIA OPEN STATE ENTRY FORM

Name:
Address: City: State/Zip::
Phone #    E-mail
Referred By:    DOB :
Parents Name (if minor) :
3 Words that Best Describe Contestant:
Hobbies, Activities:
Sponsors:

Referred by:

I have read and I fully understand the rules:
I have read and I fully understand the rules and regulations of The NES Pageant. I certify that all information contained on this application is true and correct. I understand that incorrect information can result in forfeiture of all titles/prizes received. The Owners, Directors, or Staff of The NES Pageant, or it's host hotel will in no way be held responsible for accidents, or injuries incurred during or while in transport to or from the pageant. I understand that the judges decisions are final and paying of said fees and signing this form constitutes acceptance of those decisions. Any and all photos or videos of contestants may be used by The NES Pageant for advertising and promotional materials.

Signature of Contestant OR Parent/Guardian (if contestant is under 18) and Date:

Mail deposit to:
Maria Laduca (made out to her) -  RR2 Box 4035, Henryville, PA 18332

or paypal deposit to 2010nespa@gmail.com

All questions can be directed to:

BEAUTY  $95 

Check all optionals you want to enter
Casual/Runway, Swimwear/Fitness, Natural Photogenic  

 OPTIONALS-   # @ $50 each

 EXTRA NATUAL PHOTOGENIC PHOTOS ---Extra number* @$10 

SIDE AWARDS  $40 (enters you in all 3 - PER DIVISION)  

and