2005 Izard County Fair Pageant Entry Form
Entry Form

Please circle the division entering:

0-18 mo. Baby Mr.        19 mo.—3 yr. Tiny Mr.          3-5 yr. Little Miss

0-18 mo. Baby Miss      19 mo. -2 yr. Tiny Miss         6-9 yr. Petite Miss    

10-12 yr. Young Miss    13-15 yr. Junior Miss          16-21 yr. Miss Izard County

Photogenic:  Yes_______     No______   Only _______

Name:______________________________________________________Divison:__________________

Age:_____

DOB:____________________________Address:____________________________________________

Parents:___________________________________________________Phone#:__________________

Color of Hair:_______________________________________________________

Color of Eyes:_________________________

Sponsor (optional):_______________________________________________________________________________

Hobby (optional):_________________________________________________________________________________   

Please submit registration along the $15.00 entry fee to:

2005 Izard County Fair Pageant
600 Pine Hill Street     Melbourne, AR  72556
Tiffany Webb – (870) 346-5925    Sarah Roark – (870) 368-4226 

All entries MUST be RECEIVED before September 18, 2006 or subject to a $10.00 late penalty at registration.