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2020 Miss Juneteenth Program Registration
Thank you for registering for the 2019/20 Miss Juneteenth Program. You can find more information and a calendar of events at
missjuneteenthor.org
.
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* Indicates required question
Participant Name
*
Your answer
Participant Age
*
Your answer
What is the participant most interested in participating in? Please check all that apply.
*
Program (workshops, field trips)
Mentorship
Pageant
Other:
Required
Guardian Name (if under 18)
Your answer
Address
*
Your answer
Email (of guardian if under 18)
*
Your answer
Home Phone number
Your answer
Cell Phone Number (of guardian if under 18)
*
Your answer
Can you receive text messages on your cell phone?
*
Yes
No
Yes, but I would prefer to be contacted via phone call.
Yes, but I would prefer to be contacted via email.
Participant Shirt Size
*
Youth Extra Small
Youth Small
Youth Medium
Youth Large
Youth Extra Large
Adult Extra Small
Adult Small
Adult Medium
Adult Large
Adult Extra Large
Adult 2X
Adult 3x
Other:
Please share any questions or concerns below.
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