Little Miss Breanna

SIDS Awareness Pageant

Please join us in the fight against SIDS at the First Annual Little Miss Breanna SIDS Awareness Pageant. All proceeds from this event will be donated to the American SIDS Institute in memory of Breanna Mary Bishop, daughter of Julia Pope & Chuck Bishop. Breanna became an angel on Decebmer 1, 2011 at 9 days old. There is little known about SIDS and more research is vitally necessary to prevent infant deaths from happening. Please come out and support such a great cause! August 11, 2012 4:00 PM Belle Terra, LLC. 4432 Cave Springs Road Rome, GA 30161 www.belleterraweddings.com

Registration Fee is a required $50.00 donation when you turn in the application. Registration deadline is August 1, 2012. Checks or money orders must be made out to the American SIDS Institute and must be mailed to Julia Pope at 463 Randall Rd. SW Cave Spring, GA 30124

AGE DIVISIONS
Baby Miss 0 months 14 months Toddler Miss 25 months 3 years Petite Miss 7 years 9 years Junior Miss 13 years 15 years
** Director reserves the right to combine or split any division if necessary**

Tiny Miss 15 months 24 months Wee Miss 4 years 6 years Little Miss 10 years 12 years

Rehearsal is Friday, August 10, 2012 at Belle Terra, LLC. Baby, Tiny, Toddler & Wee time is at 5:00pm. Petite, Little & Junior time is at 6:30pm.

ADMISSION: $3 per person & 5 and under FREE to the Little Miss Breanna SIDS Awareness Pageant & ALL proceeds will be donated to the American SIDS Institute
Make Checks or Money Orders Payable to the American SIDS Institute and mail to Julia Pope at 463 Randall Rd SW Cave Spring, 30124. For more information call Julia Pope (706) 252-4509 or email littlemissbreanna@ymail.com or http:// littlemissbreanna.weebly.com

Little Miss Breanna SIDS Awareness Pageant

Thank you for your interest in participating in the First Annual Little Miss Breanna SIDS Awareness Pageant. This pageant is a fundraiser for the American SIDS Institute!

Application
Saturday, August 11, 2012 at 4pm Belle Tara, LLC 4432 Cave Springs Road Rome, GA 30161 www.belleterra.com Participants Name:________________________________________________________________ Parent(s)Name:___________________________________________________________________ Age: ______________________ Date of Birth: _____________________ Email: _____________ Address: _______________________________ City: _____________________ State: ______

Zip Code: ________Home Phone: _____________________Cell Phone: ______________________ School: ______________________Clubs / Organizations: _________________________________ Hobbies or Interests: ________________________Favorite Person: ________________________ Favorite Food: ____________________________ Favorite Color: __________________________

Please check all categories you are entering: Registration deadline is August 1, 2012. Registration (Required): $50 ___________ Best Hair (additional): $10 ______________ Best Smile (additional): $10________________ Photogenic (additional): $10 __________________ (Mail photos with Application & Pageant Agreement)
** Director reserves the right to combine or split any division if necessary** Make Checks or Money Orders Payable to the American SIDS Institute and mail to Julia Pope at 463 Randall Rd SW Cave Spring, 30124. For more information call Julia Pope (706) 252-4509 or email littlemissbreanna@ymail.com

Little Miss Breanna SIDS Awareness Pageant Pageant Agreement

The Little Miss Breanna SIDS Awareness Pageant Organization and all their volunteers, agents and servants cannot be held responsible for accidents, injury or loss of personal property relating to this event, judges decisions are final. In addition, I (we) agree all photographers, film, videotape and other publicity materials resulting from my association with and participation in The Little Miss Breanna SIDS Awareness Pageant will become the property of The Little Miss Breanna SIDS Awareness Pageant Organization to be used as the organization sees fit and without compensation to me. Without limitations, The Little Miss Breanna SIDS Awareness Pageant organization shall not be responsible for any damages to property, equipment and / or clothing, bodily injury, sickness, mental anguish or death from any cause in conjunction with The Little Miss Breanna SIDS Awareness Pageant. OPTIONAL: ( pageant. LOCATION LIMITATION OF LIABILITY Belle Terra, LLC, or its employees, shall not be liable to the Contracting Guest or to any other person for any damage to property or injury to or death of any person arising from Contracting Guests use, occupancy, management, or control of the premises. Contracting Guest agrees not to bring suit against and shall indemnify and hold harmless Belle Terra, LLC, and its employees, from any and all liabilities, claims, damages, expenses, fees, fines and penalties, including attorneys fees, arising from any such cause. I have read pageant rules & application & agree to abide by them. Failure to do so may result in disqualification. **Parent Signature: ________________________________________________________ Parents Printed Name: ______________________ Participants Name: _________________ Date: ___________________________________________________________________ ) By initialing here, I (we) have given permission for The Little Miss Breanna

SIDS Awareness Pageant organization to use my name in any news related articles pertaining to the