Pageant Kingdom International 2009 Official Application

July 24-26, 2009 - Holiday Inn Hotel & Suites, Bristol, Virginia

Contestant Name:______

Birthdate:______

Parent Name:______

Valid Email Address (mandatory)______

Alternate Email Address ______

Cell Phone Number:______

Mailing Address:______

City:______State:______Zip: ______

Date Application Sent:______

How did you find out about the pageant? Check all that apply…

Internet______Paperwork ______Word of Mouth_____

Another Contestant _____ Who was it?______

(A $500 CASH Prize is given to the one contestant with the most paid referrals).

Contestant Age Group (Check age group that applies). 30 day grace period. If your birthday falls within 30 days prior to the pageant, or 30 days after the pageant, you may choose to fall back or bump up.

0-18 mths_____ 19-35 mths ______3_____ 4_____ 5_____ 6_____

7_____ 8_____ 9-10_____ 11-12_____

13-15_____ 16-19_____ 20’s_____ 30’s + _____

Our entry fee is ALL-INCLUSIVE. You pay one price for everything! Fee includes all competitions, all titles, all optionals, extra photos, talent competition (if you wish to participate). There are no door categories, no ad pages to sell, no hidden suprises. FREE ADMISSION TO ALL EVENTS. One fee covers it all! Paypal STRONGLY encouraged for payment. Contact us at today for other payment arrangements. $100 deposit due with application. Balance MUST be paid in the form of CASH at registration. Discounts earned via photo contest or guestbook drawing will be deducted at registration. Novice or Pro status for our novice awards will be determined at registration. Novices have never won more than $250 CASH with a single title.

Application should be emailed to

Paypal address for payment is

Check the fee applicable selection below.

Check appropriate selection. Select one(1) choice.

*Note that age divisions for 13-up do not make a glitz or natural selection.

ENTER NOW…

Glitz Only $295______Natural Only $295_____

BOTH GLITZ AND NATURAL $395_____

*Ages 13-up $295_____

REGULAR RATES…Take effect after Earlybird Special ends

Glitz $395 _____ Natural $395_____ Both $495_____

Ages 13-up $395_____

Total Due______

Deposit ______

Discount (only one discount accepted per contestant):______

Balance:______

I understand that Pageant Kingdom International, Mystic Productions, April Brilliant (and family), PKI Staff, Tim Whitmer, PHD Photography and Videography, and the Holiday Inn Hotel & Suites (and staff) is not responsible for any injuries sustained before, during or after the pageant. The above mentioned parties are not responsible for any lost, stolen or damaged items. I understand that the judges decision is final, and I agree to act with good conduct and good sportsmanship at all times. Any bashing of the pageant, its staff, other contestants in person, on voy boards or elsewhere will simply NOT be tolerated, and could result in disqualification, revoking of title, or if deemed necessary, legal action against the parties in question. All pageant info can be found at www.brilliantpageants.blogspot.com .

Contestant Name______

Parent/Guardian Name______

Date Noted:______

Please send your application to

Paypal payments sent to the same address