Youth Program Application | National Blueberry F

*Please be sure to fully read and understand the important information on the Youth Program page BEFORE filling out this application. Click HERE to go back.

Click here for a PDF of the Program Information and Parent/Guardian Waiver.

Youth Pageant Application

Parent/Guardian Name

Parent/Guardian Email

The Youth Pageant Ambassador Program may receive press coverage for participants or newly crowned titleholders. Should your child's name be needed for media purposes, please enter their full name as you would like it to appear below.

Participant's Full Name

What name does your child go by at home or in school?

Participant's Preferred Name

Participant's Birthday

Participant's Age on August 15, 2021

Participant's T-shirt Size

Participant's Grade (Fall 2021)

Contestant's Address (used for verifying residency only - will not be published or shared)

I certify that the participant is a year-round Michigan resident residing in South Haven, Bangor, Bloomingdale, Breedsville, Covert, Glenn, Grand Junction, or Lacota.

Hobbies or activities contestant is involved in (these will be read on stage and discussed in the interview - please be thorough)

Emergency Contact Name

Emergency Contact Phone Number

Does the participant have any medical conditions or special needs our team should be ready to accommodate?

Is the participant allergic to any food or have any special dietary needs (vegan, gluten free, etc)?

Is the participant allergic to any medications? If Yes, list medication(s)

I have read and understand the Youth Program rules, and accept the waiver. By signing below, I agree to be bound by the terms outlined in the waiver.View rules and waiver.

Parent/Guardian Signature

Cost is $25.00 per child.

Thank you! We will be in touch by email with next steps.

August 12-15, 2021

*Please be sure to fully read and understand the important information on the Youth Program page BEFORE filling out this application. Click HERE to go back.

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Youth Pageant Application