* 1. Applicant Name:

* 2. Parent/Guardian Information:

* 3. Biography, to be read at pageant. Tell us who your parents are, about your school & community involvement, hobbies & interests, & your future plans and goals.

* 4. Eligibility. The pageant is open to girls ages 15-18 (as of pageant date) who are attending or graduates of Delta High School. Please mark each box to verify that you are aware of the Pageant Requirements/Judging:

* 5. Winners General Responsibilities (no exceptions). Please mark each box to verify that you are aware of your responsibilities if you are chosen to represent Delta City as part of the Miss Liberty Royalty:

* 6. Winners 4th of July Responsibilities (no exceptions). Please mark each box to verify that you are aware of your responsibilities if you are chosen to represent Delta City as part of the Miss Liberty Royalty:

* 7. Winners other Responsibilities (Exceptions by Mayors permission only). Please mark each box to verify that you are aware of your responsibilities if you are chosen to represent Delta City as part of the Miss Liberty Royalty:

* 8. Awards. Should you be chosen as part of the Miss Liberty Royalty, winnings are as follows: Please mark each box to verify that you have read it.

* 9. RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT: RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT
I affirm that participation in the activities and services provided by Delta City Corporation are voluntary and acknowledge that there are inherent risks in such participation that cannot be eliminated even when the greatest care is taken. I assume full responsibility for any and all injuries or damages which may occur to me or my dependents as a result of such inherent risks associated with such activities or services provided by employees, sponsors, and volunteers from any liability, loss, cost or expense (including attorney fees, medical and ambulance costs) suffered by my dependents or myself. I give permission to use my (my dependents) photograph(s) to publicize Delta City programs and services.

* 10. Thank you for your interest in the Miss Liberty Contest. By clicking "Done" you will be entered in the pageant. The Pageant will be held on March 19, 2018 at 7:00PM at the Community Center, 75 W Main. Friends and family are welcome to attend. Contestants should arrive no later than 6:30PM dressed and ready to go. If you have any question or concerns, please feel free to contact the City Office at 435-864-2759. Good Luck!!

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