National Entry Form

National Director: Lee Ann Kennedy

46 Talbot St.

Somerset, New Jersey 08873

Telephone: 732-940-5633 11:00am-10: 00pm ET

Website: www.angelfire.com/biz2/milliondollarbabe

NATIONAL ENTRY FORM

Age Divisions 0-17 mo., 18-35 mo., 3-4 yrs., 5-6 yrs., 7-8 yrs.,

9-10 yrs., 11-12 yrs., 13-15yrs., 16 and Over Miss/Mrs.

Name:__________________________________________Date of Birth:_____________

Address:______________________________City: ________________ State:_______ Zip:______

Telephone:____________ Work:____________E-mail:_________________ Portable:_________________

Others:_____________Hobbies:_____________________________________________________

3 Words That Describes You:

#1:____________#2:___________#3:___________

CATEGORIES	COST	MARK
REGISTRATION BEAUTY SPORTSWEAR PRO-AM MILLION $ FACE	$150.00 *PAID* $75.00 $50.00	——— PAID ______ ______
OUTFIT OF CHOICE Overall Beauty Overall Sportswear Model	$75.00 $50.00 $50.00	______ ______ ______
PHOTOGENIC ($10.00 extra 5 maximum)	$75.00	______
Talent	$100.00	______
Cover	$75.00	______
Back Cover	$75.00	______
Centerfold	$50.00	______
Program Book	$25.00	______
Pizza Party $5.00 per person	How Many______	______
Must be at least $150.00 Reg.	and Cover/Centerfold Fees	If entering Pageant.......... ______
BALANCE DUE :	1/2 Deposit required	$___________
	Total Amount Due	$___________

Please Note: Grand Supreme Package consists of Beauty, Sportswear,
Photogenic, Million Dollar Face & Outfit of Choice,(plus $150.00 Registration Fee)
which includes 1 Parent Admission Pass,& 5 Game Tickets.

I will not hold the Director or Pageant, premises, or staff liable for any lost items, or any damages before, during, or after the pageant. I will conduct myself in a sportsmanlike manner and understand that all Judges Decisions are final. I understand any conduct that is not in appropriate mannerism will result in disqualification before, during or after pageant and will result in all forfeit of prizes.

Signature:__________________ Date:___________