To register for the pageant, please fill in the online registration form below and submit. Payment information is on the payment page. Application Contestant Name*Name of contestant competing. First Last Parent/Guardian Name*Parent or guardian if under 18. Contact person. First Last Contact Email* Date of Birth (mm/dd/yyyy)* MM DD YYYY Age Division*The age division contestant will be competing in:SELECT ONE4-6 Petite7-9 Junior10-12 Preteen13-15 Jr Teen16-19 Teen20-29 Miss30+ WomanContact Phone*Phone number of parent/guardian if under 18.Mailing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Are you a state title holder?* Yes, I am a state titleholder No, I am not a state title holder Is this your first time competing in a pageant?* Yes, this is my first time competing in a pageant. No, this is not my first time competing in a pageant. List any outstanding awards, honors, volunteer service and special accomplishments.One per line. List your hobbies or activities. List your career goals or what you want to be when you grow up. List reasons you like to give back to your community. List the title, state or country you wish to represent.*(If you already have a title, please type it in.)You must agree to the terms below to apply. Please read thoroughly.*By submitting the form above, I hereby agree to abide by the rules and regulations, directives and provisions for contestants as set forth in the Imperial Beauties of America Organization. I understand that all monies paid to Imperial Beauties of America are non-refundable, and returned checks will incur a fee of $30. I understand that state titles will be appointed in the order in which applications are received and that if a state pageant is held in my state, I will be appointed the States Capital title in lieu of competing at the stage pageant. I understand that a deposit of half of the national sponsorship fee is due within 30 days of confirmation of state/regional title, with the remainder due within 60 days of confirmation in order to secure my title. I agree to accept this state/regional title as confirmation and a commitment to compete at the national competition and will assume all responsibility for payment of national program fees. I understand and agrees to the responsibilities of being a State queen and therefore agree to its terms. I understand that if I am unable to attend nationals for any reason, I must forfeit my state title, must return the crown and sash, and I will not receive a refund of any monies paid to Imperial Beauties of America. Imperial Beauties of America has the right to refuse entry at its discretion. I further agree that my child may appear in taped segments or printed advertisements for Imperial Beauties of America in the future without compensation after said competition. Delegates and their parents/guardians hereby release and forever discharge Imperial Beauties of America Scholarship Organization, its directors, employees, volunteers and staff from any and all claims and demands arising from damages or liabilities due to theft, accident, loss or injury resulting from participation in the Imperial Beauties of America Scholarship Program. I also affirm that all of the enclosed forms are true to the best of my knowledge and belief, including name, birthday, city and state of residence. I understand any false or misleading statements will be sufficient reason for dismissal from the pageant system Delegates and their parents/guardians further covenant and agree not to sue the organization, its directors individually, its employees, volunteers or staff for any claim for damages or liability. I have read and agree to the terms and conditions.