Fill Out the Forms Below (You Must Click SUBMIT After EACH Form)

  • Please note that all fields containing an * are required and your form will not be submitted without entering a value in those fields.
  • You will receive a confirmation email after each form has been submitted.  If you do not receive a confirmation email then your form was not received by our office and you will need to reattempt submitting the form.

Fantasy Camper Profile

This will be used by our Fantasy Camp directors to learn more about you, and also to show you a modified version of what the Contestants fill out for their judges.

"*" indicates required fields

Name*
Please enter the name you wish to be called on stage.
Which grade are you in?

Questions

Corrections & Updates

Should you need to update or correct a previously submitted profile, you may complete the form as many times as needed. We will use the form that has the most current date & time of submission.


Enter Email & Submit

Email*
Your email address will only be used to send you a confirmation of your submission. This will not be included on the Camper Profile.

MC Card

This will be the information the MC will use to describe you during competition.

"*" indicates required fields

Name*
Please enter the name you wish to be called on stage.

Interests

Fun Fact 1 of 3
Fun Fact 2 of 3
Fun Fact 3 of 3

Corrections & Updates

Should you need to update or correct a previously submitted profile, you may complete the form as many times as needed. We will use the form that has the most current date & time of submission.


Email*
Your email address will only be used to send you a confirmation of your submission. This will not be included on the MC Card.

Health Information & Release of Liablity

"*" indicates required fields

Name*
Please list your mother's first and last name. Should you choose not to list anyone, please enter "None" in the field above. If your mother is deceased, please enter "Deceased."
If you did not enter your mother's name in that field, please enter "000-000-0000" in this field.
Please list your father's first and last name. Should you choose not to list anyone, please enter "None" in the field above. If your father is deceased, please enter "Deceased."
If you did not enter your father's name in that field, please enter "000-000-0000" in this field.

Release

In consideration of participating in the Miss USA State Pageant Fantasy Camp and it's related events and activities, I agree that:
1. There are inherent risks of injury.
2. I knowingly assume those risks and agree to indemnify and hold harmless, the Miss USA Organization, the Miss Universe Organization or the sponsoring state directors, Paula Miles, Ryan Miles, and RPM Productions, Inc. for all injuries sustained, except those caused by the sponsoring director’s sole negligence.
Release of Liability
MM slash DD slash YYYY
Email*
Your email address will only be used to send you a confirmation of your submission.

Media Release

"*" indicates required fields

Fantasy Camper Name*

Parent/Guardian Information

Parent/Guardian's Address

Release

MM slash DD slash YYYY
Email*