2017 Portsmouth River Days (Baby-Young) Miss Registration

Last Name

This is a required question

First Name

This is a required question

Date of Birth

This is a required question

Parent Email

We will send you communication that will require responses

This is a required question

Parent Name

Point of Contact

This is a required question

Parent Contact Phone

We need to be able to reach you

This is a required question

I intend for my child to participate in the River Days Parade

Participation for Baby-Tiny Tot is optional. Tiny to Young miss contestants should plan on parade participation. You will need to provide your own transportation for the parade and signs for your car.

Yes, my child will participate in the parade
No, my child will not participate in the parade

This is a required question

I plan to purchase a space in the Official River Days Program

You may purchase a page in the program spotlighting your child. A full page ad costs $100. 1/2 page $50.00, 1/4 page $25.00. Payments and a photo ready ad must be submitted by August 1st for publication.

Yes, I intend to purchase a program page
No, I will not be purchasing a program page
whole page $100.00
half page $50.00
quarter page $25.00

This is a required question

Please indicate below t-shirt size for fitted tshirt.

Contestants in the Tiny to Young Division are required to purchase an opening number t-shirt that will be worn to open the pageant, and will also serve as a travel top in the event that your child wins. The cost of the shirt, payable at the Sunday rehearsal is $20.00. The top will be 100% cotton and will be fitted in nature. If you are in doubt of a size, move up a size.

This is a required question

Form of payment

You must submit a form of payment for your registration to be considered complete. Please indicate your response below. We cannot accept personal checks for payment. Payments must be in the form of an electronic transaction or in the form of a cashier's check or money order.

I plan to pay using paypal
I plan to submit my payment to Portsmouth River Days c/o Regina Speas 9 Pine Bluff Court Wheelersburg, Ohio 45694

This is a required question

Parents Names

To Be Announced On Stage

This is a required question

Age/Grade/School Attending

To be announced on stage

This is a required question

My favorite color is _____?

To be announced on stage

This is a required question

My favorite thing to do is _______?

To be announced on stage

This is a required question

My favorite food is _______?

To be announced on stage

This is a required question

My favorite TV show is _____?

To be announced on stage

This is a required question

When I grow up, I want to ________?

To be announced on stage

This is a required question

The funniest thing that has ever happened to me is _______?

To be announced on stage

This is a required question

Something special about me is __________?

To be announced on stage

This is a required question

My favorite part of River Days is ________?

To be announced on stage

This is a required question

The famous person that I would like to meet is _______?

To be announced on stage

This is a required question