2016 Junior Miss Racing XtravangzaContest Entry Form
Racing Xtravangza(York, PA) –Sunday, February 7, 2016(1:00 p.m.)
Entry Fee –None (Deadline for entry: Monday, January4, 2016)
Please print clearly or type (below):Shirt Size:______Jacket Size:______
Name of Applicant:______
Parent’s Name:______
Address:______Apt. ______
City, State, Zip:______
Phone (home):______(Father):______(Mother):______
Email Address:______
Date of Birth (Age):______
Sponsor (Racing Related):______
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CONTEST RULES (Please read carefully)
1. Contestant must be female, between 6-12 years of age and sponsored by either a racing team, racing related organization, product, or vendor, but not already currently under monetary contract, or acting as Queen for any sponsor or product. All applications must be accompanied with proof of age (i.e. copy of Birth Certificate) and current photograph.
2. Contestants must report to the show office by 12:30 p.m. on Sunday, February 7 for the 1:00 p.m. contest.
3. Contest will include interview and photo sessions. Sportswear, like you might wear to the race track as a trophy presenter, will be the order of dress. Judges are looking for a fun-loving, reliable young lady to represent the Racing Xtravangza show for the year.
4. The Junior MissRacing Xtravangza 2016winner will receive a sash, trophy, and tiara. Other awards may be presented to the winner and other participants.
5. Racing Xtravangza management reserves the right to disqualify any applicant for nonconformity to the above rules.
6. Questions and photos maybe directed to Jaynee Zeigler at
AGREEMENT / RELEASE (Please read carefully)
I hereby certify that I am an independent contractor, assuming all responsibility for moneys received as a result of my participation in the Racing Xtravangzaevents, including without eliminating, income taxes, FICA, workmen’s compensation, and withholding taxes. I am not an employee, servant or agent of Racing Xtravaganza. In consideration of acceptance by Racing Xtravaganza of this application and payment of prizes, the undersigned agrees to abide by all rules and regulations of Racing Xtravaganza as to conduct and requirements, as now published in the entry form or hereafter modified.
The undersigned consents to the use of her name and/or pictures of herself for publicity, advertising, endorsements, both before and after the Racing Xtravaganza events, and relinquishes any rights to photos taken in connection with Racing Xtravaganza events, and consents to the publication or sale of such photos by Racing Xtravaganza. Any dispute, controversy or claim involving the undersigned applicant, whether or not relating to this agreement or alleged breach of the same, shall be settled in accordance with the existing and/or amended rules and regulations of Racing Xtravaganza, and the undersigned agrees to accept the decisions rendered by such process.
BY MY SIGNATURE BELOW, I CERTIFY THAT I HAVE READ AND FULLY UNDERSTAND THIS AGREEMENT. I AGREE TO ABIDE BY ALL TERMS OF THIS AGREEMENT AND THE REQUIREMENTS OF THE RULES.
Applicant’s Signature:______Date:______
Parent Signature:______Date:______
Please return this form, pictures and proof of age (signed and dated) to:
Racing Xtravangza, 419 Deerfield Drive, Hanover, PA 17331.