Entry Form

Little Miss (Ages 6-8) Pre-Teen (Ages 9-11) Jr. Miss (Ages 12-14)

Jr. Miss Galaxy Entrance Fee is $595

Please enter Contestant Name & Address below:

Parent's Name
Parent's E-mail address
Contestant's Date of Birth
Title Of Choice
2nd Title Choice
3rd Title Choice
What other pageants have you entered:
Please list any titles you've held:
How did you hear about Galaxy?

Please contact me as soon as possible regarding this matter.