Little Mr. and Miss Sylacauga

Contestant Name *

First

Last

Contestant age (as of the date of the pageant) *

Date of Birth (as of date of pageant date) *

School/Daycare Contestant Attends (if applicable) *

Which 1 or more of the eligibility requirements does your contestant meet? *

Attend Sylacauga City Schools, B.B. Comer, or Fayetteville; OR Be a Sylacauga resident for the past 30 days with a home address zip code of 35150 or 35151; OR Reside in an area where the home landline telephone would have a Sylacauga telephone prefix, for example 245, 249, 207, 208, etc.

Excerpts from the following questionnaire will be read onstage during competition and used for on-stage and/or private interview. For 0-4 year olds, feel free to put not applicable (n/a) for those fields that do not apply to your contestant.

Write a brief statement about child - personality, hobbies, interests: *

Church/Civic Involvement *

Extracurricular Activities *

Scholastic Honors *

Favorite Subject in School *

Favorite TV Show *

Pets (list type and name) *

What do you want to be when you grow up? *

Besides your mom/dad, who is your role model? *

Parent's names as they should be announced from stage. Example: John and Jane Doe OR John Doe and Jane Doe) *

Your contestant is competing in the following (check all that apply) *

Poise and Beauty Walk $50 Photogenic $10 per photo Talent $10 (talent can be no longer than 90 seconds) Interview $10 (Little contestants only)

If competing in Photogenic, how many photos are you submitting? *

My child will compete at Little Miss Marble Valley also (Yes or No) *

Will the contestant be competing in talent? If so, please provide a brief introduction to be read on stage before she/he performs. *

As parent/legal guardian of this contestant, I hereby certify that all the above statements are accurate and this contestant meets all of the eligibility requirements to compete in this pageant.

Electronic Signature of Parent/Guardian (your typed name in this field represents your consent/signature) *

Date *

YOUR CART

Saturday, April 30, 2022, at 2:00 PM
J. Craig Smith Community Center
Ages 3 - 12
Deadline: April 22
Proceeds to benefit the Miss Sylacauga Competition

YOUR CART

Saturday, April 30, 2022, at 2:00 PMJ. Craig Smith Community Center​Ages 3 - 12Deadline: April 22Proceeds to benefit the Miss Sylacauga Competition

Saturday, April 30, 2022, at 2:00 PM
J. Craig Smith Community Center
Ages 3 - 12
Deadline: April 22
Proceeds to benefit the Miss Sylacauga Competition