BABY CONTEST ENTRY FORM for JULY 19th

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The Baby Contest is being held as part of All About Musicpalooza, a youth based music performance concert and donation drive for the Manteno Veterans Home that is part of the Mokena Lions Firecracker Weekend. It takes place in the in the giant tent at the corner of Wolf Road and Front Street in downtown Mokena.

Email *

Contestants Last Name *

Contestants First Name *

Contestants Date of Birth *

YYYY

Category you are entering *

0- 3 months

3 - 6 months

6 - 9 months

9 - 12 month

12 - 18 months

18 - 24 months

24 - 36 months

First and Last Name of person accompanying child on stage for contest *

Relationship to the contestant" *

Best phone number to reach you at *

Address *

A LITTLE BIT ABOUT THE CONTESTANT

Please complete this section to let us know what we can share with the audience and judges about the contestant.

Do you have any brothers and what are their names and ages *

Do you have any sisters and what are their names and ages *

Do you have any pets? If so what kind and what are their names? *

What is your favorite thing to eat? *

Is there a special song that makes you happy? *

What do you do that makes your family smile? *

First and last name of legal guardian *

Consent for participation and publicity Box MUST be checked. *

I acknowledge that I am the contestants legal guardian and give my permission for the Contestant to participate in the baby contest.

I, the contestants legal guardian give my permission for any photos taken of the contestant to be used in all forms of publicity online and in print.

Required

A copy of your responses will be emailed to the address you provided.

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