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3X PRCA MEDIUM SIZED RODEO OF THE YEAR | PRO RODEO HALL OF FAME INDUCTEE | June 30 - July 4, 2021
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102nd Black Hills Roundup  >
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Miss Black Hills Roundup Application
Dear Potential Miss Black Hills Roundup Contestant:
We are pleased that you are considering running for the title of Miss Black Hills Roundup Queen!
Pagent: June 29, 2021
Senior Age: 18-26 (age as of January 1, 2021)
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Last Name
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Faroe Islands
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Virgin Islands, U.S
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Zambia
Zimbabwe
Postal Code
Phone Number
Parent's Name
Parent's Phone Number
Sponsor's Name
8 X 10 Color Glamor Photo
High Resolution - 300 DPI
Newspaper Biography
Limit 150 words
Short Arena Biography
3-4 sentences please
Formal Resume
One Page
Modeling Dress Script
Short Paragraph
Description of Basket/Purse for Kickoff Party
List of items in your gift
Entry Fee
Miss BHR Queen Entry Fee
Queen Pageant
$95.00
QTY
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HORSEMANSHIP AND RELATED ACTIVITIES ASSOCIATED WITH THE MISS BLACK HILLS ROUNDUP QUEEN PAGEANT RELEASE ASSUMPTION OF RISK AND INDEMNITY AGREEMENT
“I, the undersigned, represent that I am medically fit to participate in this event. In consideration of you accepting my entry, I, intending to be legally bound, do hereby for myself, my heirs, executors and administrators waive and release forever all rights and claims or damages I may accrue against all persons and agencies involved with promoting the Miss Black Hills Roundup Queen Pageant and any and all activities related to the Miss Black Hills Roundup Queen Pageant. Further, I hereby grant full permission to any and all the forgoing to use any photographs, video tapings, or other recordings of the competition for any purpose whatsoever.
Wavier for Miss Black Hills Roundup Queen Pageant
If you have any questions, please contact Coordinator Tara Olson.
Phone: 605-641-8272
Email: tarathompson001@hotmail.com
Address: 20265 Superior Place, Whitewood, SD 57793
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