2023 Application

YOU MUST COMPLETE THIS APPLICATION WITH YOUR PARENT OR GUARDIAN PRESENT!

YOU MAY NOT SIGN FOR YOUR PARENT OR GUARDIAN!

IF YOU SIGN FOR YOUR PARENT OR GUARDIAN YOUR APPLICATION WILL NOT BE ACCEPTED!

YOU MUST ALSO PAY THE $25 ENTRY FEE BEFORE YOUR APPLICATION WILL BE ACCEPTED-LINK AT BOTTOM OF APPLICATION.

The Miss 22 Quties Beauty Pageant provides an opportunity for young ladies with special needs who are between the ages of 14 and 25 to participate in an event that builds friendships and instills confidence. This group of young ladies competes for the title of Miss 22 Qutie. The pageant also includes recognition of the First and Second Runner Up, and Miss Congeniality.

To be considered for participation in Miss 22 Quties, applicants must:
• be between the ages of 14 and 25 (age limit does not apply to 2020 applicants) as of the day of the pageant and have a disability.*
• be one of the first 25 girls to complete an application, be reviewed, and accepted.
• be physically present at the 3 mandatory practices and 5 out of 7 remaining practices.
• be able to fully comply with the Participant Agreement that follows.
• meet the criteria outlined by the Americans with Disabilities Act:

According to the Americans with Disabilities Act, an individual with a disability is a person who: has a physical or mental impairment that substantially limits one or more major life activities, or has a record of such an impairment, or is regarded as having such an impairment.

Participants will:
• perform an opening dance as a group.
• share their individual talents.
• participate in a Q&A session with the judges.

Application Disclaimer: Miss 22 Quties Beauty Pageant is limited to 25 participants. Applicants will be reviewed and considered in the order in which their completed application packet is received.

Pageant and all practices will be held at

Victory Family Church, 21150 Route 19,
Cranberry Twp., PA 16066.

Applicants must reply YES to the following pageant requirements.

Check YES to agree to each of the following statements. By checking YES, you agree to comply with each rule. READ THOROUGHLY.

Attend the following mandatory practices: Tuesday, May 23, July 25 (lighting and rehearsal), and August 1 (full rehearsal). Parent/legal guardian must be present for all of these practices. Missing any of these practices will make you ineligible to participate in the pageant

YES

Attend at least 5 of the 7 non-mandatory practices leading up to the pageant beginning on Tuesday, May 23. Practices will be on Tuesday evenings from 6:30 to 8:30 p.m. with the exception of Dress Rehearsal which will be at 5:30 p.m. Please note: missing more than 2 of these practices will make you ineligible to participate in the pageant.

YES

Attend the professional headshot session by our official pageant photographer. Date TBA. Only these headshots, taken by our official photographer, will be accepted for the program.

YES

Wear an evening gown during the Q&A portion of the pageant.

YES

Participate in the day-of preparation.

YES

Participate in the REQUIRED FUNDRAISER - The Zroni Pepperoni Roll Fundraier. Each child must sell a minimum of 3 rolls - The highest seller will win a prize.

YES

Read all communications and respond as requested via email. All communication is handled via email, unless otherwise specified.

YES

Applicant Information

First Name

Last Name

Birthdate

Age as of 08/06/2023

Phone

Parent/Guardian Information

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Phone

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Emergency Contact Information

Emergency Contact Name

Emergency Contact Last Name

Relationship with Applicant

Parent/Guardian Phone

Applicant Talent

My Talent in the Pageant Will Be (Your Talent Will Be Limited to 2 Minutes)

At the end of the pageant, one contestant is selected to give an advocacy speech directed to the special needs community. The focus of this speech is to share the contestant’s goal(s) for impacting this amazing community.

The contestant is welcome to share her story and experiences as part of this speech.

Speeches are limited to two minutes. They must be written by the contestant, to the best of her ability. Assistance may be provided if necessary. Speeches will be given and evaluated prior to the pageant. One speech will be selected for presentation. More details will be provided during pageant preparation.

I am interested in trying out to give an advocacy speech at the pageant.

YES

Special Consideration/ Important Information

Using third person (she instead of I), please tell us a little bit about yourself, include things that not many people know.

You may include information such as: your job (if you work), education (were/are you involved in any extracurricular activities, do you plan on attending/did you attend college or trade school), volunteer work, participation in clubs/groups, etc.

You may also want to include who or what inspires you and why you are inspired by this person or thing.

Please indicate these things in paragraph form in third person. This will be used as your bio in the pageant program. This should be a minimum of 100 words and a maximum of 200 words.

Please provide us with two questions you would prefer the judges to ask you during the question and answer portion of the pageant. For example: Who inspires you and why? What do you want to do when you grow up? What do you enjoy?

Question 1

Question 2

LIABILITY RELEASE

I have agreed to act as a contestant while participating in the following activity described as a beauty pageant/nonprofit event on August 06, 2023.

Applicants must reply YES to each of the following three (3) statements.

I am fully responsible for any and all the risks and dangers associated with transportation to and from the Miss 22 Quties Special Needs Beauty Pageant.

YES

I agree that Miss 22 Quties, Victory Family Church, any other sponsors/providers, and their employees, agents, and contractors, shall not be legally responsible for any loss, injury or damage resulting from any cause, including negligence of any party.

YES

I agree to assume all risks in connection with this activity including, but not limited to, risks associated with the location and any actions I may take while participating. To the fullest extent allowed by law I agree to RELEASE, HOLD HARMLESS, and INDEMNIFY Miss 22 Quties, Victory Family Church, their employees, agents or contractors from any liability for death, loss, injury or other damage which may occur during or as a result of this Activity or during transportation to and from this Activity, whether foreseen or unforeseen.

YES

PHOTO RELEASE

I hereby authorize Miss 22 Quties/Dave Higginbotham permission to use my likeness in a photograph and/or video in any and all of its publications. I understand and agree that any photograph and/or video using my likeness will become property of Miss 22 Quties/Dave Higginbotham and will not be returned.

I acknowledge that since my participation with Miss 22 Quties/Dave Higginbotham is voluntary, I will receive no financial compensation.

I hereby authorize Miss 22 Quties/Dave Higginbotham to edit, alter, copy, exhibit, publish or distribute this photo and/or video for purposes of publicizing Miss 22 Quties/Dave Higginbotham programs or for any other related, lawful purpose. In addition, I waive the right to inspect or approve the finished product, to royalties or other compensation arising or related to the use of the photograph and/or video.

I hereby hold harmless and release and forever discharge Miss 22 Quties/Dave Higginbotham from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have reason of this authorization.

I have read this release before signing below and I fully understand the contents, meanings, and impact of this release.

YES

GENERAL RELEASE

THE TERMS OF THIS AGREEMENT SHALL ACT A RELEASE AND ASSUMPTION OF RISK FOR MY HEIRS, EXECUTORS, ADMINISTRATORS, AND ALL MEMBER OF MY FAMILY, INCLUDING ANY MINORS ACCOMPANY ME. I UNDERSTAND THIS IS A BINDING CONTRACT THAT SUPERSEDES ANY OTHER AGREEMENTS OR REPRESENTATIONS AND IS INTENDED TO PROVIDE A COMPREHENSIVE RELEASE OF LIABILITY BUT IS NOT INTENDED TO ASSERT ANY DEFENSES WHICH ARE PROHIBITED BY LAW. THE SPECIFIC RIGHTS OF THE PARTIES MAY VARY FROM STATE TO STATE. IF ANY PART OF THIS RELEASE IS DEEMED UNENFORCEABLE, ALL OTHER PARTS SHALL BE GIVEN FULL FORCE AND EFFECT. I HAVE CAREFULLY READ AND UNDERSTAND THIS AGREEMENT, AND I AM AWARE THAT BY SIGNING THIS AGREEMENT I AM WAIVING CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE. I SIGN THIS RELEASE AGREEMENT OF MY OWN FREE WILL.

I have read the general release and I fully understand the contents, meanings, and impact of this release.

YES

ACKNOWLEDGEMENT OF JUDGING

PARTICIPANTS WILL BE EVALUATED BY A PANEL OF JUDGES IN THREE MAJOR CATEGORIES: EVENING GOWN, TALENT AND QUESTION AND ANSWER.

I have read the acknowledgement of judging and I fully understand the contents, meanings, and impact of this release

YES

PARENTAL CONSENT

I give my consent for my child to participate in this pageant.

I also agree to RELEASE, HOLD HARMLESS, and INDEMNIFY Miss 22 Quties, Victory Family Church, Profiles Styling Salon, any other sponsors/providers, and their employees, agents and contractors for any claims of my child. I agree to be responsible for any medical expenses incurred by my child.

I have read the parental consent and I fully understand the contents, meanings, and impact of this release.

YES

ENTRY FEE

Miss 22 Quties charges a one time fee of $25 to submit your application. This fee covers essential fees of the pageant.

Applicant Signature

IF YOU SIGN FOR YOUR PARENT OR GUARDIAN YOUR APPLICATION WILL NOT BE ACCEPTED!

Parent/Guardian Signature

Thanks for applying to volunteer with us! We'll get back to you soon.