Miss
Gay Ohio America Official Preliminary
Contestant Information
-
All applications must be submitted on or before July 1, 2012 unless otherwise approved in advance by Believe Entertainment.
- Administrative point deductions will be applied to contestant scores for contestants who have not submitted their applications by the application deadline. For every five days delay in receipt, a “per infraction” administrative point deduction will be levied.
- Administrative point deductions will be applied to contestant scores for improperly or partially completed applications. Please be reminded that Administrative Point Deductions carry forward into the Final Night scores.
- The application must be submitted in Microsoft Word format and sent to Believe Entertainment electronically. No handwritten or faxed applications will be accepted.
- Please follow these instructions to complete the application:
- Input the information in the appropriate “gray” box (as the information is input, the grey box will expand and subsequent information may shift downward accordingly… if the application seems to be “off-page aligned”, please do not be alarmed as this will be remedied by the national office, when the application is received and processed ) then;
- “tab” to the next box (DO NOT press the “enter” key after information is input into the box or all subsequent information will be shifted to the next line)
- Once the application is completed, save as
“Application-SusieSmith-MGA2010” (please use stage name of contestant)
- Send an email to with the application as an attachment.
- OPTIONAL- click “request return receipt”, if possible, to ensure you are automatically notified when the application is retrieved by the national office
- The Contestant Application should be sent as an attachment, electronically, to L & T Entertainment at the email address of. Upon receipt of the application, will provide an email confirmation of receipt (to both the promoter and the contestant) to advise you that the application received is acceptable.
- Limited changes to your application (concerning talent), once submitted, will be allowed. Please contact f or necessary changes.
- Contestant signatures for various places on the application will be obtained at the time of registration or as otherwise specified.
- Dancer/On-Stage performers signatures for Performance Release will be obtained at the time of registration or prior to talent competition, as announced.
Contestant # _____________
Miss Gay Ohio America 2012
Contestant Information
Given Name:
Stage Name:
Qualification to enter (if applicable):
Birth Date: Age:
Address:
City: State: ZIP:
Telephone:
Email address:
Sponsor(s)
Employer:
Occupation:
Hobbies:
In case of an emergency, please notify:
Relationship of person to notify, in case of an emergency:
Have you judged any Miss Gay America Official Preliminaries, during the Miss Gay America 2012 pageant season? Yes or No If yes, please explain:
Are there any physical disabilities, handicaps, or any other information you think we should know in order to better help you? Yes No If so...please explain below.
Questions I would like to be asked during interview (Male Interview or On-Stage Interview) are:
1)
2)
3)
4)
Contestant # _____________
Miss Gay Ohio America 2012
Contestant Attestation
By entering the Miss Gay America Pageant, I, agree, should I be selected as the Official Miss Gay America, I will be obligated to conform to the standards of acceptance (to be determined by L & T Entertainment) for personal bookings whether it is to perform, entertain, emcee, or otherwise appear at any show, contest, benefit, function, parade, or gathering. Any and all said performances and appearances will be approved, in advance, through the executive office of L & T Entertainment. I also agree that I will not utilize silicone or other type of body enhancement product or injection below the neck during my reign as Miss Gay America. Failure to comply with these rules will be cause for immediate forfeiture of the crown, title of Miss Gay America, all prize money awarded (un-disbursed or disbursed) and appearance stream as the official Miss Gay America. It is further agreed that in the event that the title and crown are revoked, I clearly understand that I may be required to repay any cash prize, including the value (determined by L & T Entertainment) of the non-cash prizes received, as a result of my selection as Miss Gay America. I clearly understand and acknowledge that the rules and regulations and my commitment to L & T Entertainment, is transferable to the successor and or assigns of L & T Entertainment.
Furthermore, I agree to appear at the next Miss Gay America Pageant, without compensation, other than the remainder of the prize package due to Miss Gay America. Only lodgings for the nights of the pageant will be provided. I understand that I will be responsible for the prompt payment of all other expenses at the time they are incurred. L & T Entertainment will furnish a contract and job description, for my employment during my reign as Miss Gay America, which shall be signed prior to the official commencement of my reign as Miss Gay America. I have previously read and understand the job descriptions of Miss Gay America and will abide by the job description requirements and other requirements from L & T Entertainment, including but not limited to those noted in the Miss Gay America Promoters Handbook and Contract for Employment.
By signing below, I agree that I have received, read, clearly understand and agree to the verbiage detailed in all of the Miss Gay America pageant system information including but not limited to:
The Miss Gay America Job Description Summary
The Miss Gay America Contestant and Promoter Rules and Regulations
The Miss Gay America Entertainer/Emcee Regulations
The Miss Gay America Contestant Release
The Miss Gay America Dancer-On Stage Performer Release
The Miss Gay America Promoters Handbook
I further attest that all of the information submitted as part of the Miss Gay America 2012 Contestant Application is true and accurate. By signing below, I further attest that my Stage Name and Given Name are one in the same, for the purpose of acknowledging and agreeing to all of the terms and conditions of the Miss Gay America pageant system, now known or hereafter deemed (by L & T Entertainment, it successors and/or assigned) to be policy and procedure of the Miss Gay America pageant system.
Stage name:
Given name:
Signature: _______________________________________________ Date: _____________
(to be signed at the time of registration, at 10:00 a.m. on 10-07-2010):
Witness: _______________________________________________ Date: _____________
(to be signed at the time of registration) Date of signature
Contestant # _____________
Miss Gay Ohio America 2012
Lighting Request Worksheet
(Preliminary Talent Competition)
STAGE NAME:
I HAVE TALENT PROPS? YES NO
I NEED ELECTRICITY ? YES NO
I NEED SET UP TIME? YES NO
I HAVE DANCERS/ON-STAGE PERFORMERS IN MY TALENT.
MY TALENT IS MINUTES IN LENGTH.
Please note any special lighting requests. (lighting requests will be limited but attempts will be made to accommodate your request):
Each dancer/on-stage performer that is in your talent will be required to sign the Miss Gay America Dancer/On-Stage Performer Release Form, prior to performing in the talent competition. These forms must be signed prior to the talent competition category…Forms will be provided on the evening of the talent competition. No performer will be allowed to participate in a talent number without completion of the Release Form…there will be no exceptions. Said Release Form will include the printed given name and signature. Photo identification will be required.
Miss Gay Ohio America 2012
Lighting Request Worksheet
(Final Night Talent Competition-if applicable)
STAGE NAME:
CONTESTANT NUMBER: (to be completed at registration)
I HAVE TALENT PROPS? YES NO
I NEED ELECTRICITY ? YES NO
I NEED SET UP TIME? YES NO
I HAVE DANCERS/ON-STAGE PERFORMERS IN MY TALENT.
MY TALENT IS MINUTES IN LENGTH.
Please note any special lighting requests. (lighting requests will be limited but attempts will be made to accommodate your request):
Each dancer/on-stage performer that is in your talent will be required to sign the Miss Gay America Dancer/On-Stage Performer Release Form, prior to performing in the talent competition. These forms must be signed prior to the talent competition category…Forms will be provided on the evening of the talent competition. No performer will be allowed to participate in a talent number without completion of the Release Form…there will be no exceptions. Said Release Form will include the printed given name and signature. Photo identification will be required.
Ccontestant # _____________
Miss Gay Ohio America 2012
Contestant Release
I, , a contestant in the Official Miss Gay America Pageant, do hereby hold harmless and waive all rights to any claim or lawsuit against: L & T Entertainment or its employees, agents, distributors and/or assigns, or the Official Miss Gay America Pageant (the “Pageant”) and its representatives (together the “Releasees”) arising out of or related to the Pageant and/or my participation in the Pageant to the extent permitted by law. I also grant the “Releasees” the right to videotape, photograph, sound record, film or otherwise use my name, likeness, image or voice in any television program, documentary or other film, or the internet or in any media now known or hereafter known or any advertising or promotion thereof in connection with or relating to the Pageant. I understand I have no right to and shall not receive any monetary payment for any photograph or recording (audio or video) in which I may appear in connection with or relating to the Pageant.
I enter all activities during the course of the Pageant, past , present or future, at my own risk and expense. I also agree to hold harmless from liability, the owner, employees and affiliates of any official site/location(s) of the Miss Gay America pageant.
I agree that my appearance and performance in the Pageant and all related activities shall constitute a work for hire. In the event such is not deemed a work for hire, I hereby assign, transfer and convey any and all interest in any copyright I may own, or have a right to, relating to my appearance and performance in the Pageant and its related activities, past, present or future to L & T Entertainment, it successors and/or assigns.
I understand the winner and first alternate agree to represent the title of Miss Gay America and appear as requested with advance notice. Should the winner be unable to fulfill the commitment as Miss Gay America, the title will revert to the first alternate or other representative chosen by L & T Entertainment.
I attest that my stage name and performances do not infringe on any copyright protections. In the event it is deemed that such infringement is evident, I will immediately remedy such infringement, including but not limited to modification of my stage name and performance. I understand that I am solely responsible for claims against me for copyright infringement and that L & T Entertainment, its successors and/or assigns shall be held harmless.
I further agree that any of my actions which are deemed as demeaning to the crown (as determined by the owners of the Miss Gay America pageant) or the Pageant during my year as Miss Gay America are sufficient grounds for immediate and complete revocation of the title of Miss Gay America, the crown, all prize monies (un-disbursed or disbursed,) and all performance fees received as Miss Gay America. I agree to honor the ruling of the owners of Miss Gay America as the final deciding authority. I further agree I will abide by and be held accountable to follow the “Standards of Conduct for Titleholders” as adopted for use by the Miss Gay America Pageant system. I further acknowledge that I have read, understand and agree to abide by the contestant regulations and information noted in the Miss Gay America job description summary. Likewise, I will sign a contract, to validate my employment with the Miss Gay America pageant system. I further acknowledge that there will be no disbursement of prize money or awards and that my reign, as Miss Gay America, will not officially commence, until the contract has been executed.
This agreement may be assigned by L & T Entertainment and/or the Pageant to any third party. This agreement shall apply to all past, present and future performance with the Miss Gay America pageant system.
Stage name:
Given name: Date:
Signature _____________________________________ Date: ________________
(to be signed at the time of registration):
Contestant # _____________
Miss Gay Ohio America 2012
Dancer/On-Stage Performer Release
(one form per contestant, which should be signed by all “Dancer(s)/On-stage performer(s)
I, we, as Dancer(s)/On-Stage Performer(s) for , a contestant in the Official Miss Gay America Pageant, do hereby hold harmless and waive all rights to any claim or lawsuit against: L & T Entertainment or its employees, agents, distributors and/or assigns, or the Official Miss Gay America Pageant (the “Pageant”) and its representatives (together the “Releasees”) arising out of or related to the Pageant and/or my participation in the Pageant to the extent permitted by law. I also grant the “Releasees” the right to videotape, photograph, sound record, film or otherwise use my name, likeness, image or voice in any television program, documentary or other film, or the internet or in any media now known or hereafter known or any advertising or promotion thereof in connection with or relating to the Pageant. I understand I have no right to and shall not receive any monetary payment for any photograph or recording (audio or video) in which I may appear in connection with or relating to the Pageant.
I enter all activities during the course of the Pageant at my own risk and expense. I also agree to hold harmless from liability, the owner, employees and affiliates of any official site/locations of the Miss Gay America pageant.
I agree that my appearance and performance in the Pageant, including any performance of past, present or future, and all related activities shall constitute a work for hire. In the event such is not deemed a work for hire, I hereby assign, transfer and convey any and all interest in any copyright I may own, or have a right to, relating to my appearance and performance in the Pageant and its related activities to L & T Entertainment, its successors and/or assigns.
I further agree any of my actions which are deemed as demeaning to the pageant system (as determined by the owners of Miss Gay America) or the Pageant, are sufficient grounds for immediate and complete revocation of; privilege to participate in any Miss Gay America sanctioned event, all monies (un-disbursed or disbursed,) and all performance fees. I agree to honor the ruling of the owners of the Miss Gay America pageant as the final deciding authority. I further agree I will abide by and be held accountable to follow the “Standards of Conduct for Titleholders” as adopted for use by the Miss Gay America Pageant. I acknowledge that my given name is one and the same as any “stage name” I may now use, or hereafter acquire.
This agreement may be assigned by L & T Entertainment and/or the Pageant to any third party. It is understood that when executed, this Release Form applies to any event on camera, whether moving or still photography, of any past, present or future officially sanctioned event of the Miss Gay America pageant system. Furthermore this Release applies to any involvement of the Miss Gay America pageant system, albeit past, present or future involvement. By signing below, I attest that my given name is one and the same as any “stage/performer name” that I have, whether now known or hereafter acquired. By signing below, I hereby express written understanding of the aforementioned.
Given name of the On-Stage Performer (printed):
Given name signature:________________________________ Date:_______________
Given name of the On-Stage Performer (printed):
Given name signature:________________________________ Date:_______________
Given name of the On-Stage Performer (printed):
Given name signature:________________________________ Date:_______________
Given name of the On-Stage Performer (printed):
Given name signature:________________________________ Date:_______________
Given name of the On-Stage Performer (printed):
Given name signature:________________________________ Date:_______________
Given name of the On-Stage Performer (printed):
Given name signature:________________________________ Date:_______________
Contestant # _____________
Miss Gay Ohio America 2012
Solo Talent Questionnaire
(This will be read during “stall time” needed for judging of the Solo Talent Category)
-I NEED “black out/set-up” TIME? YES NO
-Contestant Stage Name:
-City:
-State:
-Sponsors:
-Three words used to describe my competition journey are:
-One fact that people would be surprised to know about me is:
-I should be Miss Gay America because (20 words or less):
-My mentor in the Miss Gay America pageant system is and why? (20 words or less):
-Horoscope sign:
-My motto in life is:
-Favorite musical instrument:
-Favorite song:
-Favorite movie:
-Favorite Color: Favorite Singer/Band:
-Favorite Food:
-My favorite category of the Miss Gay America pageant system is: and why?
Contestant # _____________
Miss Gay Ohio America 2012
Evening Gown Questionnaire
(This will be read during the Evening Gown competition)
-Contestant Stage Name:
-City: State:
-Sponsors:
-Make-up stylist: -Hairstyle is by: -Gown Designer:
-My fundraising platform is : why? (in 20 words or less)
-In my female persona, I am sometimes mistaken for:
-As I get older, I feel more:
-The best beauty advice I have ever received is:
-The worst beauty advice I have ever received is:
-The best advice given to me by my mother is:
-The worst advice given to me by my mother is:
-The best advice given to me by my promoter is:
-A song written, that best applies to my life is:
-The movie title that best describes my life is:
-My favorite punch line from a joke is:
-My favorite line or quote from a movie is:
-I am most worried about…
- makes me happy!
- makes me sad!
-I sometimes get angry when .
-If I am not chosen to be Miss Gay America 2012, my advice to Miss Gay America 2012 is (20 words or less) .
Contestant # __________________
Miss Gay Ohio America 2012
Talent Questionnaire
(This will be read during prop set up/take down and stall-time, needed for judging)
I have talent props? Yes No
I need set-up time? Yes No
Talent Length (minutes)
Dancers: Yes No If yes, how many dancers?:
-Contestant Stage Name:
-City: State:
-Sponsors:
-My most positive quality is:
-My most negative characteristic is:
-My greatest accomplishment to date is:
-My ultimate goal in life is to:
-I spend my “free time” doing:
-If I didn’t look like me, I’d like to look like:
-My idea of a perfect evening is:
-My advice to a newcomer in female impersonation would be (20 words or less):
-My pet peeve is:
-Previous titles held, in the Miss Gay America pageant system include:
-Other titles (other systems and non-system related) held include:
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