Application and Release Form

M.V.P. 2010
Ms. Virtuous Pageant
Participant Application & Release Form

Please Print

Name:___________________________________________________

Nickname:___________________________________

Primary phone number:( )__________ Cellular number:( )__________

Home Address: ____________________________________________

City, State, Zip_____________________________________________

Email Address:_____________________________________________

Age:_____ Birth Date:___/_____/____ Height:_______

Dress Size:_______ T-Shirt Size:________ Shoe Size:_______

Are you a legal U.S. Resident? ________

Do you smoke or drink alcohol?________

Marital Status:_________________

Within the last 30 days, (from the date of this application) have you participated

in premarital sex?______

What is the highest level of education you have completed? (circle one)
High School College (AA Degree) College (BA, BS degree) Masters Degree

Doctoral Degree

Are you a member of any church? If so, please list: ____________________

_____________________________ Phone:____________________

Occupation:_______________________________________________

Hobbies:_________________________________________________

Talents:__________________________________________________

Have you ever been charged with a felony? (if yes, please explain) ____________

___________________________________________

Have you ever been convicted of a felony?(if yes, please explain) _____________

__________________________________________

List your biggest challenge:____________________________________
_______________________________________________________

List something you would like to accomplish that you have never done before:

_______________________________________________________

_______________________________________________________

Is there anything about you we should know that might impact your ability to

participate in the MVP Pageant?__________________________________

________________________________________________________

________________________________________________________

In your own words, briefly explain how you accepted Jesus Christ as your personal

Lord and Savior.
________________________________________________________

________________________________________________________

________________________________________________________

Requirements:

You may apply to be a contestant by completing, signing and submitting this application and returning it to Pastor Tina Jones. Make payments to Ms. Virtuous Pageant.

1. A non-refundable application fee of $TBD, paid by cash, cashier's cheque, or money order is due with application post marked TBD. A non-refundable application fee of $TBD will be assessed for applications post marked TBD and/or received on the interview date TBD.

2. Once selected as a contestant, you will be responsible to raise $TBD of sponsorship money and sell 10 admission tickets @ $TBD to the Ms. Virtuous Pageant 2009, TBD.

3. All monies that are given to or raised for M.V.P. through fees, sponsorships, and donations are non-refundable.

4. You must be willing to travel at your own expense to be interviewed at Central State University. You must also be available for potential callbacks on TBD. Please bring a completed application with you to the interview.

5. You must be at least 18-35 years of age.

6. You must be a United States citizen and currently live in the United States.

7. You must be in good mental health.

8. All decisions are made at the discretion of the visionary and the visionary reserves the right to change the rules at any time.

9. Material Submissions: For any material you submit during this application process, you agree to permit the visionary, its licensees and assigns, the non-exclusive use of any photographs, artwork, and/or videotape (the submitted materials) for use in any and all media, worldwide, now known or hereafter developed and in all advertising and promotion of the casting event, the production, the visionary, and its licensees and assigns. You represent and warrant that you own all right, title and interest (including all copyrights) to the submitted Materials sufficient and necessary to grant the permission described above, free and clear of any conflicts with any third party rights and can release and hereby releases the visionary, its licensees and assigns from any claim or other cause of action arising out of the use of the submitted materials.

10. You agree that the visionary may tape and photograph you and record your voice during and in connection with the casting and/or production. You agree that the visionary shall be the exclusive owner of all copyright and other rights in and to such taping, photography, and recording and shall have the right forever and throughout the world to use and license others to use the results of such taping, photography and recording and recording in any manner the visionary wishes in any medium, whether now known or hereinafter invented. You further agree that the visionary may use license others to use your name, voice, and likeness in the advertising and promotion of the casting event and production.

11. You further agree that the visionary shall have no liability and you shall hold the visionary harmless from, for any liability, claim, action, damage, expense incurred by you or any third party arising from my participation in privacy, publicity or personality, or personal injury, death or other injury or accident. Please note: If you make any false statement(s) the visionary may withhold you from participating in the casting call and/or the production or related activities, and the visionary may make announcements, on-air or otherwise in order to explain or disclose your false statement(s).

12. All monies for MVP through sponsorships, donations, and fees are non-refundable.

Acknowledged and Agreed to:

Printed Name:_____________________________________________

Signature:________________________________________________

Address:_________________________________________________

Phone Number:_________________________________________________

Date:______/_________/__________

*All Dates are subject to change.

Ms. Virtuous Pageant

The Proverbs 31 Woman