Miss Iowa Resource Portal
Dr. Jennifer Caudle Women in STEM Scholarship
Emily Tinsman Scholarship for the Arts
Miss Paperwork
Teen Paperwork
Local Executive Directors
Princess Camp
Judging Seminar Materials
2022 Princess Camp Registration Information:
*
Indicates required field
Name
*
First
Last
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Phone Number
*
Email
*
Cell Phone Number
*
Parent or Guardian Full Names
*
Age as of June 1st, 2022
*
Birth date
*
How did you hear about Princess Camp? (If recruited by contestant, please list their name.)
*
Optional: Miss/Teen Candidate that you would like to be partnered with:
*
T-shirt size (One Princess Camp shirt included in registration fee.)
*
Child Small
Child Medium
Child Large
Adult Small
Adult Medium
Adult Large
Additional T-shirt ordering (If you would like additional Princess Camp T-shirts, please note quantities and sizes. Additional fee of $15 per shirt should be added to fee total.) Size options: Child Small, Child Medium, Child Large, Adult Small, Adult Medium, Adult Large, Adult XL, Adult 2X
*
Enter sizes or N/A
Registration Payment Form
PRINCESS CAMP FEES:
$300
$280 SIBLING DISCOUNT RATE (1ST PRINCESS PAID AT FULL PRICE)
$250 RETURNING PRINCESS WITH HER MISS IOWA PRINCESS CROWN
$60 REPLACEMENT MISS IOWA PRINCESS CROWN
ALL PRINCESS CAMP FEES ARE NON-REFUNDABLE
MAIL CHECK TO
(Note-Photo must still be emailed):
Miss Iowa Scholarship Program
Attn: Princess Camp
P.O. Box 1595
Davenport, Iowa 52809
Registration Fee:
*
Additional T-shirt Fee:
*
Registration Fee Total:
*
Select from the following payment types:
*
Check
Credit (Please fill our Credit Card section.)
Sponsorship (Please fill out sponsorship section of registration.)
Venmo (@Lisa-Durbin-2)
PayPal (Admin@missiowa.com)
Credit Card Number (Mastercard, Visa, Discover)
*
Amount of Check:
*
Security Code and Expiration Date:
*
Total amount to be charged to the card:
*
Cardholder's Name/Billing Address/City/State/Zip/Phone
*
Electronic Signature acknowledging payment amount to be charged to credit card:
*
Sponsor Form (Optional)
I agree to sponsor a Miss Iowa Princess and understand the contribution is non-refundable. This sponsorship payment will entitle me or company to be listed as a Princess camp sponsor in the Commemorative Miss Iowa Program Book.
Name of sponsoring person or business:
*
Phone Number
*
Email address:
*
Princess Emergency Contact Information:
Emergency Contact:
*
Family Physician Name and Phone Number
*
Known Allergies:
*
List of all medications and vitamins/supplements child is currently taking:
*
Physical issues/problems that could cause your Princess discomfort:
*
List of people your Princess can be released to and what is their relationship to the Princess:
*
Photography Release:
Permission to Use Copyright Negative of Print and Website Release. As photographer and copyright owner of attached negative(s) or print(s), I grant permission for my negative or print to be used in connection with the Miss Iowa, Miss Iowa's/Miss Iowa's Outstanding Teen and/or Miss Iowa Princess Camp and any commercial activity emanating therefrom as well as for the purpose of producing photo cards, invitation, announcements or miscellaneous social or commercial stationary items as selected by one or more of the principals in the photographs. The negative or print cannot be used for any purpose other than listed above except for publicity or Miss Iowa Program and its affiliates and printing by a commercial printing firm in the Miss Iowa Program Book. I also grant permission for the use of these photographs on the Miss Iowa websites and/or Miss Iowa Program affiliated social media sites. I understand and agree that all such permitted uses here under shall be without compensation to me for the same. This agreement shall be binding, valid and enforceable against and the benefits thereof shall insure to, the parties' successors, licensees, assigns and parties in the privacies with them.
Photographer Name/Business Name:
*
Business Address
*
Line 1
Line 2
City
State
Zip Code
Country
Photographer Phone Number
*
Electronic Signature that all photography information is accurate:
*
Statement of Understanding:
As parents or legal guardian of ______________________________, we submit her application for
approval. We agree to conduct ourselves at all times in a professional manner. We will ensure that our
daughter will conduct herself in a proper manner at all times and will be prompt to all Miss Iowa
Princess Camp activities. We understand that this is NOT a competition, but a mentoring and learning
experience conducted by the Miss Iowa Scholarship Program.
TRANSPORTATION, HOUSING AND MEALS
I further understand that I will need to furnish transportation to all Miss Iowa Princess Camp activities. I
acknowledge that Miss Iowa Princesses and their families are responsible for their own housing and
meals during Miss Iowa Pageant week.
General Rules and Guidelines
Any Princess whose conduct is deemed unbecoming by the Miss Iowa Princess Camp Committee or Miss
Iowa Board will be asked to withdraw from the Miss Iowa Princess Camp and will no longer be eligible
for future participation. Princess Camp fee is non‐refundable.
No one is permitted backstage at any time except security, stage personnel, pageant officials and
production members. Miss Iowa Princesses will only be allowed backstage when accompanied by a
pageant official.
No one will be permitted in the Adler Theatre dressing rooms except authorized personnel. Miss Iowa
Princesses should plan to arrive for the evening portion of Princess Camp dressed in production
wardrobe, as specified by Princess Camp officials.
Please direct any problems or complaints to the Princess Camp Coordinator, Andrea Riley or Miss
Iowa Board Representative immediately so that they can be resolved in a timely manner.
Please have your Princess arrive on time for Princess Camp. Tardiness results in scheduling delays and
must be avoided.
Please label your child’s belongings before arriving at Princess Camp. The Miss Iowa Scholarship
Program is not responsible for lost or stolen personal items.
I hereby waive and release the Miss Iowa Scholarship Program Management Corporation from any and
all liability for any injuries or illnesses incurred while at Princess Camp. I will be responsible for any
medical or other charges in connection with my daughter’s attendance. I know of no medical or physical
problem which may affect my child’s ability to safely participate in this Miss Iowa Princess Camp.
Electronic Signature (acknowledging statement of understanding):
*
Submit
2022 Princess Ad Sales Incentives - OPTIONAL
File Size:
177 kb
File Type:
pdf
Download File
2022 Program Book Ad Placement & Pricing Form
File Size:
152 kb
File Type:
pdf
Download File
