Early Bird Registration

Delegate First and Last Name*

Title Requested*

Date of Birth*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Age*

Please enter a number from 1 to 99.

Age on July 1, 2023*

Please enter a number from 1 to 99.

Phone*

Parent Email*

Contestant Email*

Parent Name*

Parent Phone*

Agreement*

I understand that I am required to attend the 2023 International Pageant in Orlando, FL. July 8-16, 2023.

Agreement*

I understand that if for any reason I am unable to compete at the 2023 International Pageant, I will be required to return my state crown, sash and any other prizes given to me in the condition it was received (or pay all replacement costs) within 10 business days.

Agreement*

As a State Titleholder, I promise to use my title to help promote the Royal International Pageant system by making a minimum of 10 appearances throughout my 12 month reign including returning to my own state pageant in 2022-23 (if held) to crown my successor.

Agreement*

If I do not choose to pay my 2023 International Pageant fees ($750 all inclusive fee which includes the $100 scholarship fee) up front, I understand that I will be responsible for making monthly payments in the amount of $150.00 to the International office beginning the 12th of the month following my registration. I understand that I will be required to have a Credit card set-up (information below) on auto pay to fulfill this obligation. All fees paid are non-refundable.
Please complete all fields below. You may cancel this authorization at any time by contacting us. This authorization will remain in effect until cancelled.
Amount to be debited each month will be $150.00. Amount will be debited on the 12th day of the month until the balance is paid in full. If balance is not paid by June 1, 2023, I authorize Royal International Miss to debit the remaining balance on this card on June 1, 2023.
I authorize Royal International Miss to charge my credit card above the agreed upon purchases. I understand that my information will be saved to file for future transactions on my account. I understand that this agreement stays in effect until balance is paid in full and that there are no refunds for any monies paid.

Name on Credit Card*

Card Number*

Expiration Date (mm/yy)*

Security Code*

Cardholder Zip Code (from billing address)*

I authorize Royal International Miss to charge my credit card. Signature*

Agreement*

I understand that this contract with Royal International Miss includes a morality clause and a restricted non-compete clause. The morality clause states that all delegates must be in good moral standing, must have never posed nude in any form of media, must be a natural born female, and that the delegate agrees to adhere to our standards of acceptable behavior.

Agreement*

I understand that if I am crowned with an International title at the 2023 International Pageant, I will be required to sign an International Titleholder Contract which contains a restricted non-compete clause. The restricted non-compete clause states that as an International Titleholder, the delegate may not compete for any other National or International title that would require them to relinquish or in any way jeopardize their title with Royal International Miss.

Agreement*

I understand that if I am crowned as an International Titleholder that I will receive fifty percent (50%) of my total cash scholarship upon signing the official 2023 Royal International Miss International contract, and the remaining fifty percent (50%) will be awarded at the completion of my reign.

Agreement*

I agree to abide by all rules and regulations set forth by Royal International Miss. All Delegates and their parents or guardians hereby release and forever discharge Royal International Miss Scholarship Organization, its directors, employees, staff and volunteers from any and all claims and demands arising from damages or liabilities due to theft, accident, loss or injury resulting from my participation in the Royal International Miss Program. Royal International Miss has the right to refuse entry at its discretion.

Agreement*

I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above terms and conditions.

Signature

Early Bird Registration*

Price:

Credit Card

Card Details

Cardholder Name

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