CONTESTANT APPLICATION

Personal Information

Name: __________________________________________________________________

Address: ________________________________________________________________

Phone: ______________________ Age: ____________ Birthday: __________________

Education

Jr. High School: __________________________________________________________

High School: __________________________________ Graduation Year: ___________

College: ______________________________________ Graduation Year: ___________

Occupation

Employer: ______________________________ Address: ________________________

Position: _______________________________ Phone: __________________________

Emergency Contact Information

Name: ___________________ Address: ________________________ Phone: ________

Name: ___________________ Address: ________________________ Phone: ________

Personal References

Name: ___________________ Address: ________________________ Phone: ________

Name: ___________________ Address: ________________________ Phone: ________

Name: ___________________ Address: ________________________ Phone: ________

Hobbies?

________________________________________________________________________

Why do you want to be Ms. Gold Dust Rodeo Queen/Junior Queen?

________________________________________________________________________

________________________________________________________________________

When and why did you first become interested in rodeo?

________________________________________________________________________

________________________________________________________________________

What contributions do you believe a Rodeo Queen can make to benefit the sport of rodeo?

________________________________________________________________________

________________________________________________________________________

I hereby understand and agree to the rules and procedures of the Gold Dust Rodeo Queen/Junior Queen Pageant. I understand and agree that the Gold Dust Rodeo Queen Committee reserves the right to rule on any matter not covered by the rules and procedures, and that their decision will be final.

I hereby waive any liability against the Gold Dust Rodeo Queen Committee for any injury, loss or damage to any person or property arising out of the Gold Dust Rodeo Pageant whether such injury, loss or damage occurs as a result of theft, accident, negligence, or otherwise.

Note: If the Gold Dust Rodeo Queen Committee does not receive minimum of 5 entries there may not be a Queen Pageant.

Contestant Signature:___________________________________Date:_______________

Parent or Guardian Signature:___________________________ Date:_______________