Miss Xcalibur Club 2010 Pageant Contestant Application

Name: ______________________________ Date: ______________

Stage Name: _________________________ D.O.B.: ____________

Note: Registration will be at 5 pm day of the pageant.

Address: _______________________________________________

City: ____________________________ State: _____ Zip: _______

Phone: _____________________ Mobile: _____________________

E-mail: _________________________________________________

Sponsors: _______________________________________________

Tell us about yourself: ______________________________________

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Tell us about your costume/dress: ____________________________

________________________________________________________

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Goals: __________________________________________________

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What would this title mean and how would you represent the club

should you win: ___________________________________________

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Note: Use additional space on the back as needed

For Promoter use only

Talent: Lip Sink ____  Live ____  Dance ____ Props____ Other _____

Entry Pd ____ Descriptive Cards ____ Talent # ____ Crown # ____