Central States Application | usunitedpageant

Central States Official Application

First name

Last name

Birthday

Month

Day

Year

Street Address

City

State, Zipcode

Phone

Email

How did you learn of the U.S. United Pageant?

Are you currently holding any national titles?

YES

NO

I agree to forever hold the United Pageant Productions and Foundation, U.S. United Pageant System, its directors, employees, volunteers, and staff members harmless of any, and all claims and damages or liabilities due to theft, accident, loss, or injury during or resulting from my or my child's participation in the 2026 U.S. United Pageant or any U.S. United Pageant Preliminary/State/Regional Program or activity/event.

I understand that I am required to pay a $25 registration/processing fee and a $175 pageant fee. I am also required to sell 10 tickets to the event.

FEES ARE NON REFUNDABLE/NON TRANSFERABLE.

Application Fee-includes Paypal fee

Application Fee must be uploaded with application. (includes Paypal fee)$27

My electronic certifies that I have read all of the information on the website and the answers to my questions are true to the best of my knowledge.

Parent Signature if contestant is under 18

Central States Official Application

AFTER YOU CLICK SUBMIT, YOU MUST COME BACK AND PAY USING THE PAYPAL BUTTON