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America's Regal Gems
TRIPLE TREAT
October 7-9, 2016
Tiki Resort in Lake George NY
This form registers you for ARG system ONLY. You must register for each system separately. Thank you for choosing our pageant system
Please remember your $50 is non refundable and should be paypaled to RegalGemsPageant@aol.com
Questions email Cheryl at RegalGemsPageant@aol.com
Contestant Name
First
Last
Parent/Guardian
First
Last
Email
Phone
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###
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####
Date of Birth
Age Division - 30 day fall back
Please select
0 23
2 yr
3 - 4
5 - 6
7 - 8
9 - 10
11 - 12
13 - 15
16 & up
Supreme fee $125 includes Beauty and Costume
$
Dollars
.
Cents
Please choose Glitz or Natural
Glitz Beauty
Natural Beauty
Optional OOC $20 May be used in place of Costume for Supreme score
Check if entering
Glitz Photo $20
Check if entering
Natural Photo $20
Check if entering
Print Model or Comp Card $20
Check if entering
Total
Deposit - $50 minimum deposit required
Paypal ($52) - RegalGemsPageant@aol.com
$
Dollars
.
Cents
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