EmailMe Form - 2015 Miss Portland Pajama Pageant

Contestant Name *

Age Division (Age as of August 30, 2015)

Parents Name

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Phone Number *

### - ### - ####

Parents Email *

Referred by: *

ENTRY FEE AND INSURANCE
Includes Mandatory Competition Events and 1 chaperone admission. $10 fee if 1 pair of pajamas is not turned in at registration.
($75)

$ Dollars . Cents

Mini Optionals

MINI OPTIONAL FEE
($10 each or all 6 for $30)

$ Dollars . Cents

OPTIONAL CASUAL WEAR
($25)

$ Dollars . Cents

ADULT Admission
$5 each

$ Dollars . Cents

CHILD Admission (Ages 3-12)
$5 each

$ Dollars . Cents

I wish to register for the August 30, 2015 Portland Pajama Pageant *

Yes, I agree.