Official Entry Form

2020 Miss Poway Scholarship Program  

 

Name   ______________________________________   Date of Birth ____________________ 

Home Address ________________________________________________________________

City _________________________         Zip _________  

Home Phone  _______________________ Contestant Cell Phone ______________________ 

Contestant E-Mail Address ______________________________________________________

Parent Email Address  __________________________________________________________

Parent Cell Phone   _____________________________________

School ___________________________________        Grade or level ____________________  Emergency Contact Information: 

Name ______________________________________ Relationship _______________________ 

Home Phone _______________________            Cell Phone ____________________________ 

 

There is no entry fee to participate in the pageant.  To defray the costs of the pageant and contribute to Poway Kiwanis Club charities, each contestant will be responsible for obtaining sponsors via sales of program advertisements totaling at least $380.  Any contestants obtaining total advertisement sales exceeding $380 will receive 10% of the amount over $380 as a “commission” to help with her pageant expenses. 

 

By my signature below I establish my wish to enter as a contestant in the                              2020 Miss Poway Scholarship Program:

 

Contestant Signature ____________________________________Date__________________  Parent or Guardian Signature if

Contestant is under 18 ___________________________________Date__________________ 

 

 

 

 

 

 

 

    WAIVER OF LIABILITY AND ASSUMPTION OF RISK   

 

I, ____________________________________________________________, attest that I am appearing in  

The Miss Poway, Miss Teen Poway, Miss Junior Teen Poway and Miss Pre Teen  Scholarship Program voluntarily and in so doing I assume all of the risks arising from my participation in such a pageant.  In addition, should I be awarded a title as a member of the Miss Poway, Miss Teen Poway, Miss Junior Teen and Miss Pre-Teen Poway Court,  I voluntarily agree to participate in the activities of that office, and again, I assume all risks associated with such activities.  I forever release, discharge, and covenant to hold harmless The Poway Kiwanis Club, the Miss Poway Program, its officers, directors, employees and volunteers,  the City of Poway, and the Poway Center for the Performing Arts from all liability of loss, damage, or injury to person or property arising out of or incident to my performance in the Miss Poway,  Miss Teen Poway, Miss Junior Teen Poway and Miss Pre-Teen Poway Scholarship Program or, in the event of my selection to such, the performance of my subsequent duties as a member of the Miss Poway, Miss Teen Poway, Miss Junior Teen Poway and Miss Pre-Teen Poway Court,  including, but not limited to, all damages to person or property whether or not resulting from the negligence of The Poway Kiwanis Club, the Miss Poway Program organization, and its officers, directors, agents, representatives and employees. 

I hereby assume all risks to myself associated with the production and presentation of this pageant and with my subsequent activities during my reign as a titleholder, should I become a titleholder as a result of the pageant.  I certify that I have entered into the competition with no reservations whatsoever in this regard. 

 

Executed on _______________________, at _________________, California. 

 

 

_________________________________________

                      Contestant Signature   

IF CONTESTANT IS A MINOR, PARENT(S) MUST SIGN BELOW: 

I/We, the parent(s) of ______________________________, have read the foregoing and agree to all of the terms and conditions included in this Waiver of Liability and the Assumption of Risk document for and on behalf of my/our daughter. 

 

 

__________________________________        _____________________________________

                         Parent Signature                                             Parent Signature

 

                        

  

ARBITRATION AGREEMENT 

THIS ARBITRATION AGREEMENT (“Agreement”) is made as of the date of execution noted below and between The Poway Kiwanis Club (“Club”) and the contestant for The Miss Poway Scholarship Program (“Contestant”) identified below. 

WHEREAS, Club and Contestant, the parties to this Agreement, wish to resolve any and all disputes concerning participation of Contestant in The Miss Poway Scholarship Program or Contestant’s subsequent performance of duties as a titleholder following the pageant through binding arbitration. 

IN CONSIDERATION, of the mutual benefits of the covenants and agreements contained herein, the parties hereby agree as follows: 

1.      Effective Date:  The term “Effective Date” shall mean the first date on which both parties have signed this Agreement.

2.      Any controversy or claim arising out of or relating to Contestant’s participation in The Miss Poway Scholarship Program or Contestant’s subsequent performance of duties as a titleholder following the pageant shall be settled by arbitration, governed by the laws of the State of California and the County of San Diego.  Judgment on any award rendered by the arbitrator(s) may be entered in any court having jurisdiction thereof.

3.      This Agreement contains the entire understanding of the parties and supersedes any previous verbal or written agreements or representations between the parties concerning the matters set forth herein.

4.      Alterations, amendments, or modifications of a provision of this Agreement shall not be binding unless such alteration, amendment, or modification is in writing and signed by an authorized representative of each party.

5.      This Agreement may be executed in multiple counterparts, each of which shall be an original, but which together shall constitute one and the same instrument.

 IN WITNESS WHEREOF, this Agreement has been executed on the Effective Date   _______________________, 2019  at _________________, California. 

 

 

_________________________________________               _________________________________________                

                      Contestant Signature                                              Sharon Gruber, Program Director, for The Poway Kiwanis Club

 

 IF CONTESTANT IS A MINOR, PARENT(S) MUST SIGN BELOW: 

I/We, the parent(s) of ______________________________, have read the foregoing and agree to all of the terms and conditions included in this Waiver of Liability and the Assumption of Risk document for and on behalf of my/our daughter. 

 

 

__________________________________________    __________________________________________

 

                         Parent Signature                                         Parent Signature