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)

First Name

Last Name

Email Address

Sign me up for email updates

Age

Date of Birth

Address Line 1

Address Line 2

City

State

Country

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

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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