Registration

Register ONLINE!
We are excited that you have decided to join us for the first annual Queens for a Cure pageant!
Please help us prepare to make this a wonderful event for you and your family by completing the registration
form below. Please fill out one form per contestant. If you have already sent in your entry form and fees, you do not
need to complete the form below.

CONTESTANT REGISTRATION

Contestants Name: Contestant Age:

Date of Birth:

Address:

City: State: Zip:

Contestant Email: Contestant Phone:

Parents Name:

Referred By:

Age Division:

I plan to raise a minimum $100 additional donation for the Race for the Cure

Eye Color: Hair Color:

Favorite TV Show / Movie:

Favorite Book:

Ambition:

Queens for a Cure Registration Includes Mandatory Events and One Chaperone Badge	$50.00
Optionals Best Dress Best Model Prettiest Hair Prettiest Eyes Best Smile Best Introduction	$5.00 ea $25.00 all
Rose Pre-Order Single Rose $4 Three Roses $10 Roses will be available the pageant for family and friends to purchase for their favorite contestant.	$4.00/1 $10.00/3
Contestant Photo All contestants names will be printed in the program book. If you would like your contestants photo printed in the book, the fee is $10. Photos must be received by October 30th and must be emailed to queensforacure@comcast.net. BONUS - all photo submissions will be judged by a separate panel of judges and the highest scoring photo will be printed on a FULL page in the program book! The winner will also receive a banner and crown from Queens for a Cure!	$10.00
Admission Children $3ea (3-12 yrs) Adults $5ea	$
	$TOTAL

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Queens For A Cure
November 7, 2009
Renton Civic Theater
507 South Third Street
Renton , WA 98055

Hostesses: Kennedy Miller & Victoria Knight
Directors: Heidi Krajewski, Nicole Miller,
Virgie Flascher and Carol Roberts
Royalty Coordinator: Taylor Wall

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