Required Forms - MISS LOUISIANA USA and MISS LOUISIANA TEEN USA

Fill Out the Forms Below (You Must Click SUBMIT After EACH Form)

Please note that all fields containing an * are required and your form will not be submitted without entering a value in those fields.
You will receive a confirmation email after each form has been submitted. If you do not receive a confirmation email then your form was not received by our office and you will need to reattempt submitting the form.

Title & Sash agreement Contestant Profile MC Card Health Information Rules & Regulations Final Sponsorship List Media Release

Title & Sash Agreement

"*" indicates required fields

I, the contestant, understand, agree, and will abide by the follow:

Upon acceptance into the state pageant, I will be assigned a title. This title will reflect where I live, work, or attend school. Title assignments are flexible, but the approval of my title is at the discretion of RPM Productions, Inc.
My title designation is for the purposes of competing in my State Pageant ONLY. This may include soliciting sponsorships and appearances promoting the State Pageant and my area of representation.
All appearances utilizing my title must be approved in advance by RPM.
A sash reflecting my title will be given to me upon check in at the State Pageant and may be kept as a memento.
Usage of my title will be terminated upon the completion of the State Pageant.

Name*

First Last

Title*

Example: Greenville | Pearl River | Johnson County

Age Division*

Contestant Signature*

Parent/Guardian's Name

First Last

Parent/Guardian's Signature

Email*

Enter Email Confirm Email

Your email address will only be used to send you a confirmation of your submission.

Contestant Profile

Entries are closed. No changes will be accepted.

MC Card

Entries are closed. No changes will be accepted.

Health Information & Release of Liablity

"*" indicates required fields

Name*

First Last

Title*

Example: Greenville | Pearl River | Johnson County

Age Division*

Pageant Weekend Emergency Contact - Name*

(Other than your own)

Pageant Weekend Emergency Contact - Phone Number*

(Other than your own)

Relationship to Contestant*

Current Medications*

Medical Conditions*

Medication Allergies (e.g. Penicillin)*

Mother's Name*

Please list your mother's first and last name. Should you choose not to list anyone, please enter "None" in the field above. If your mother is deceased, please enter "Deceased."

Mom's Cell Phone*

If you did not enter your mother's name in that field, please enter "000-000-0000" in this field.

Father's Name*

Please list your father's first and last name. Should you choose not to list anyone, please enter "None" in the field above. If your father is deceased, please enter "Deceased."

Father's Cell Phone*

If you did not enter your father's name in that field, please enter "000-000-0000" in this field.

Release

In consideration of participating in the MISS USA® or MISS TEEN USA® State Program and its related events and activities, I agree that:

There are inherent risks of injury.
I knowingly assume those risks and agree to indemnify and hold harmless, the Miss USA Organization, and the state directors, Paula Miles, Ryan Miles, and RPM Productions, Inc. for all injuries sustained, except those caused by the sponsoring director’s sole negligence.

Release 1*

I, the contestant, have read this release of liability and assumption of risk agreement, fully understand its terms and sign it voluntarily.

Release 2

I, the parent or legal guardian of above named contestant, have read this release of liability and assumption of risk agreement, I fully understand its terms and sign it voluntarily.

Contestant Signature*

Contestant - Date Signed*

Parent/Guardian Signature

Only required if Contestant is under 18

Parent/Guardian - Date Signed

Email*

Enter Email Confirm Email

Your email address will only be used to send you a confirmation of your submission.

Rules & Regulations

Please review the Rules & Regulations, fill out your name and age divsion, then sign below.

"*" indicates required fields

To run a smooth and enjoyable event, we ask contestants to observe a few simple rules. We thank you in advance for your cooperation.

There will be no smoking in public. Your room is non-smoking and you will be held financially responsible for any damages should you choose to smoke. The pageant does not advocate smoking.
You must participate in all pageant activities and wear pageant identification at all times.
When not in your hotel room, you must be in the company of a pageant chaperone. Do not venture off by yourself. You are not permitted to visit your parents’, family’s, or friends’ rooms once registered with the pageant.
The pageant schedule is very busy! You are required to be on time.
The pageant will provide breakfast, lunch, dinner and snacks as designated on your itinerary. You will be responsible for any other meals.
As per theater rules, you are not permitted to eat except in specified areas.
No interviews for radio, television or newspaper are to be granted without prior consent of the State Director, Co-Director, or Contestant Coordinator.
Any phone calls or incidental expenses will be your responsibility.
Security is provided, however we cannot be responsible for your safety if you disregard the rules.
We are not responsible for valuables. Do not bring expensive jewelry or large amounts of cash. Be sure to mark your clothes and other items for easy identification.
You must ride the bus when indicated on the schedule. No one is allowed to drive between the hotel and theater.
You, your parents, friends, relatives, etc., are not to engage the judges or auditors in conversation prior to the conclusion of Saturday night’s pageant.
Only specified RPM Productions team members will be permitted backstage during the pageant. Pageant personnel will be available to assist to you.
Cell phones must be turned off during rehearsals and shows.
Do not attempt to meet your significant other during breaks.
All rehearsals are closed to the public.
You are not permitted to solicit or sell any products or goods during the pageant weekend to any other contestants, friends, family, or pageant staff.
You must depart the theater immediately following the crowning of the new winners.

The following rules, if broken, constitute grounds for disqualification.

There will be no consumption of alcoholic beverages or any illicit drugs, regardless of age.
Personal hairdressers, makeup artists, coaches, or parents and other visitors will not be allowed in your hotel room, nor will you be permitted to go to their rooms during the pageant weekend.
Coaches, parents or other visitors will not be allowed backstage. You will have access to pre-approved hair and makeup artists backstage.
All contestants must meet the requirements set forth by the Miss USA Organization.

Remember: If you witness any of these rules being broken, it is your responsibility to report the infraction to your chaperone or RPM team member. Failing to do so makes you guilty by association.

Name*

First Last

Title*

Example: Greenville | Pearl River | Johnson County

Age Division*

Contestant Signature*

Email*

Enter Email Confirm Email

Your email address will only be used to send you a confirmation of your submission.

Final Sponsorship List

Entries are closed. No changes will be accepted.

Media Release

"*" indicates required fields

Name*

First Last

Title*

Example: Greenville | Pearl River | Johnson County

Age Division*

Address*

Street Address Address Line 2 City State ZIP Code

Parent/Guardian Information

Parent/Guardian's Name*

Parent/Guardian's Address

Street Address Address Line 2 City State ZIP Code

Parent/Guardian's Cell Phone*

Release

I, the undersigned, do hereby consent and agree that JC Productions, Sage Media Group, RPM Productions, Inc., its employees, or agents have the right to take photographs, videotape, or digital recordings of me beginning on the date of the 2023 Miss Louisiana USA/Miss Louisiana Teen USA Preliminaries and ending on the date of the 2023 Miss Louisiana USA/Miss Louisiana Teen USA Finals, and to use these in any and all media, now or hereafter known, and exclusively for the purpose of live or delayed webcasting and DVD sales. I further consent that my name and identity may be revealed therein or by descriptive text or commentary.
I do hereby release to JC Productions, Sage Media Group, RPM Productions, Inc., its agents, and employees all rights to exhibit this work in print and electronic form publicly or privately and to market and sell copies. I waive any rights, claims, or interest I may have to control the use of my identity or likeness in whatever media used.
I understand that there will be no financial or other remuneration for recording me, either for initial or subsequent transmission or playback.
I also understand that JC Productions, Sage Media Group, RPM Productions, Inc., is not responsible for any expense or liability incurred as a result of my participation in this recording, including medical expenses due to any sickness or injury incurred as a result.

Contestant Release*

I, the contestant, have read this release form and understand the foregoing statements, and am competent to execute this agreement.

Contestant Signature*

Contestant - Date Signed*

Parent/Guardian Release

I, the parent or legal guardian of above named contestant, and have read this release form and understand the foregoing statements, and am competent to execute this agreement.

Parent/Guardian Signature

Only required if Contestant is under 18

Parent/Guardian - Date Signed

Email*

Enter Email Confirm Email

Your email address will only be used to send you a confirmation of your submission.

Cart

Fill Out the Forms Below (You Must Click SUBMIT After EACH Form)

Title & Sash Agreement

Contestant Profile

MC Card

Health Information & Release of Liablity

Release

Rules & Regulations

Final Sponsorship List

Media Release

Parent/Guardian Information

Release

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