EmailMeForm
Queens for a Cure 2016-2017 Registration
We are excited that you have decided to join us for the EIGHTH annual Queens for a Cure pageant!
November 5, 2016
Renton IKEA Performing Arts Center
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 Name
*
Parents Name
Address
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Aruba
Bahamas
Barbados
Belize
Canada
Cayman Islands
Cook Islands
Costa Rica
Cuba
Dominica
Dominican Republic
El Salvador
Grenada
Guatemala
Haiti
Honduras
Jamaica
Mexico
Netherlands Antilles
Nicaragua
Panama
Puerto Rico
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Trinidad and Tobago
United States
Argentina
Bolivia
Brazil
Chile
Colombia
Ecuador
Guyana
Paraguay
Peru
Suriname
Uruguay
Venezuela
Albania
Andorra
Armenia
Austria
Azerbaijan
Belarus
Belgium
Bosnia and Herzegovina
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Faroe Islands
Finland
France
Georgia
Germany
Greece
Hungary
Iceland
Ireland
Italy
Kosovo
Latvia
Liechtenstein
Lithuania
Luxembourg
Macedonia
Malta
Moldova
Monaco
Montenegro
Netherlands
Norway
Poland
Portugal
Romania
San Marino
Serbia
Slovakia
Slovenia
Spain
Sweden
Switzerland
Ukraine
United Kingdom
Vatican City
Afghanistan
Bahrain
Bangladesh
Bhutan
Brunei Darussalam
Myanmar
Cambodia
China
East Timor
Hong Kong
India
Indonesia
Iran
Iraq
Israel
Japan
Jordan
Kazakhstan
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Lebanon
Malaysia
Maldives
Mongolia
Nepal
Oman
Pakistan
Palestine
Philippines
Qatar
Russia
Saudi Arabia
Singapore
Sri Lanka
Syria
Taiwan
Tajikistan
Thailand
Turkey
Turkmenistan
United Arab Emirates
Uzbekistan
Vietnam
Yemen
Australia
Fiji
Kiribati
Marshall Islands
Micronesia
Nauru
New Zealand
Palau
Papua New Guinea
Samoa
Solomon Islands
Tonga
Tuvalu
Vanuatu
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cameroon
Cape Verde
Central African Republic
Chad
Comoros
Democratic Republic of the Congo
Republic of the Congo
Djibouti
Egypt
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Gibraltar
Guinea
Guinea-Bissau
Cote d'Ivoire
Kenya
Lesotho
Liberia
Libya
Madagascar
Malawi
Mali
Mauritania
Mauritius
Morocco
Mozambique
Namibia
Niger
Nigeria
Rwanda
Sao Tome and Principe
Senegal
Seychelles
Sierra Leone
Somalia
South Africa
Sudan
Swaziland
United Republic of Tanzania
Togo
Tunisia
Uganda
Zambia
Zimbabwe
Country / Region
Email
*
Phone Number
*
###
-
###
-
####
Birth Date
*
Age on November 1, 2016
Age Division
Choose One
Baby (0-2 years)
Princess (3-5 years)
Jr Preteen (6-8 years)
Preteen (9-11 years)
Jr Teen (12-14 years)
Teen (15-17 years)
Miss (18-26 years)
Ms (27+ years)
Referred By
I plan to raise $100-$499 additional donation for the Race for the Cure
*
Yes
No
I plan to raise over $500 additional donation for the Race for the Cure
*
Yes
No
Hair Color
Eye Color
Special Awards Received
Hobbies
Ambition
Queens for a Cure Registration
Includes Mandatory Events and One Chaperone Badge
$75 per person
$
Dollars
Mini Optionals
Best Dress
Best Model
Best Hair
Best Smile
Best Introduction
Prettiest Eyes
Mini Optionals
$5 each or $25 for all (See above)
$
Dollars
COVER MODEL
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 25th 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 the back cover of the program book! The winner will also receive a banner and crown from Queens for a Cure and the title of COVER MODEL!
$10 for the FIRST photo
$5 each additional Photo
$
Dollars
PERFECTLY PINK MODEL
It's all about pink! Submit any photo that features the color PINK to be considered for this contest! Photos must be received by October 25th 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 the back cover of the program book! The winner will also receive a banner and crown from Queens for a Cure and the title of PERFECTLY PINK!
$10 for the FIRST photo
$5 each additional Photo
$
Dollars
TALENT
Only the FIRST 20 talents registered and paid for will be eligible to compete. The cost to enter is $50. You must be entered in the main competition to be eligible to compete in the talent competition. We will award 1 Overall Talent Winner and one winner in each age division. If 20 entries are received we will award 1 Overall Jr Talent and 1 Overall Sr Talent. The Overall Talent winner(s) will receive a satin embroidered banner, exclusive QFAC pink ribbon crown and will join the 2017 royalty at all events including the photo shoot! The winners in each age division will receive a PINK Trophy
$
Dollars
Roses - Presented on Stage during Parade of Formal Wear
$5 for Single rose
$10 for Bouquet of Three Roses
$
Dollars
Child Admission
$3 ages 3-12 years
$
Dollars
Adult Admission
$5 ages 13+
$
Dollars
PRE ORDER!
We will have a limited number of DOLL CROWNS available for purchase at the pageant. These are perfect for American Girl Dolls. PREORDER your crown by SEPTEMBER 1, 2016 to be sure we have one for you at the pageant. $25
$
Dollars
I have read and agree to the Terms of Service
*
Yes, I agree.
Powered by
EMF
Form Builder
Report Abuse
