Contestants name: __________________________________
Mailing
Address:____________________________________
City:_________________
State: _______ Zip:_____________
Email: ____________________________________________
Phone number: _____________________________________
Parent’s names:
____________________________________
Female:
_________________ Male: _____________________
Age: ___________________ Date of Birth: _______________
Eye color: ___________________ Hair color: _____________
Favorite Food: ____________ Favorite TV Show: _____________
Favorite Movie: ____________ Favorite Pastime: _____________
Sponsored by: ____________________
Division:
(Check One)
Girls
0-11months_____
12-23 months_____ 24-47 months______
4-5
years _____ 6-7 years______ 8-11 years_____
12- 15 years_____ 16-19
years _____ Mrs._____
Boys
0-11 months_____ 12-23 months_____ 24-35 months_____ 3-5 years_____ 6+ years_____
Kentucky
UMMI Rules and Regulations
Signed__________________________________________________
Date_____________________________________________________
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