Name*
First
Last
Date of Birth* Pageant Division*
I will be at least 14 but under 19 years of age on January 1, 2024* Because you answered False it is our understanding that you will be under the age of Fourteen on January 1, 2024, which means that you will not meet the minimum age requirement to enter the pageant. OR you are over the age of nineteen by January 1, 2024, which means that you are not eligible for the TEEN division. Please be sure to fill out the correct agreement. If you feel like you have reached this message in error, please contact Pageant Headquarters at info@missnewjerseyusa.com
Name of Parent or Guardian*
First
Last
Residency 1(e) I now reside and have resided in my State as my “permanent and primary residence” (as defined below) for a period of at least ninety (90) consecutive days immediately prior to the date of the State Pageant. “Permanent and primary residence” or “permanent and primary residency” means my true, fixed and permanent domicile which I intend to make my permanent home. In order to establish my permanent and primary residence in the State, I must satisfy either 1(e)(1), 1(e)(2), or 1(e)(3) regarding the residency:
Teen Residency: Please select either 1(e)(1) ; 1(e)(2) ; or 1(e)(3)* Teen Residency: If none are applicable, please explain:*
Other Contracts (g) I acknowledge that prior to the date of the State Pageant, I did not compete in another state’s pageant preliminary to the 2024 Miss Teen USA Pageant for a period of at least ninety (90) consecutive days before the date of the state pageant, unless I am 16 years of age or older as of January 1, 2024, and I qualify to compete in another state's pageant under both, paragraphs 1 (f)(1) and 1 (f)(2) above. I further understand and agree that I may not compete in more than two (2) State Pageants preliminary to the 2024 Miss Teen USA pageant.
Teen Other Contracts: Is the foregoing statement TRUE or FALSE* Teen Other Contracts: If the above is not true & you answered FALSE, please explain:*
l) I represent and warrant that either:
Teen Other Contracts 2: Please select either 1(k)(1) or 1(k)(2). If you select 1(k)(2), then please provide copies of any such contract, agreement, or endorsement.* If neither Paragraph applies, please explain so that eligibility can be determined (please attach additional pages if necessary):
Employment Conflicts Teen Employment Conflicts: Is the foregoing statement TRUE or FALSE* Teen Employment Conflicts: If above is not true, and you answered FALSE, please complete the following, so eligibility can be determined:*
I understand that any such employment or relationship(s) may affect my eligibility for the State Pageant and, if I win the State Pageant, the 2024 Miss Teen USA Pageant. If any of the foregoing conditions changes before or during competition at the State Pageant, I will immediately give you notice of this fact so that you can make a determination as to my eligibility in your sole judgment. In addition, I acknowledge and agree that (i) you may, in your sole judgment, render eligible or ineligible, as the case may be, any person with such employment or relationship(s) and (ii) you may, in you sole judgment, render ineligible any person who, in your sole judgment, is sufficiently acquainted with any person or entity connected with the production, administration, or judging of the State Pageant or Miss Teen USA Pageant such that her participation in the State Pageant could create the appearance of impropriety.
Appearances I have NEVER appeared on any television contest, game, competition, or reality show or applied to be a contestant or participant on any television contest, game, competition, or reality show, and I have NEVER appeared, or agreed to appear, in any other television show or motion picture, online show or the like.
Teen Appearances: Is the foregoing statement TRUE or FALSE* Teen Appearances: If the above is not true, and you answered FALSE, please complete the following, so eligibility can be determined:*
I understand that any such appearances or applications may affect my eligibility for the State Pageant and, if I win the State Pageant, the 2024 Miss Teen USA Pageant. If any of the foregoing conditions changes before or during competition at the State Pageant, I will immediately give you notice of this fact so that you can make a determination as to my eligibility in your sole judgment.
Activities (a) I represent that at all times prior to the date of this Agreement, I have conducted my activities and life in accordance with the highest ethical and moral standards and that I have never been arrested or charged with the commission of a crime (including, without limitation, reckless or drunk driving or minor in possession of alcohol or illegal possession or use of drugs ) or engaged in any activities that might bring myself, you, Miss Universe, the State Pageant, the Miss Teen USA Pageant, the Miss Teen USA Pageant system, the Parties, or any of their respective subsidiaries, affiliated or related companies, officers, directors, partners, shareholders or employees into public disrepute, ridicule, contempt or scandal or might otherwise reflect unfavorably upon any of the foregoing individuals or entities or might shock, insult or offend the community or any class or group thereof. I acknowledge that, by way of example, and without limiting the generality of the foregoing in any way, having appeared in public or permitted myself to be photographed in a state of partial or total nudity or in a lewd, compromising or sexually suggestive manner constitutes a violation of this provision (this includes photographs, images or videos that may appear on any web site or social media platform, such as Instagram, Facebook or YouTube or that may be recorded or captured privately [and is distributed to any other person or entity).
Activities: Is the foregoing statement TRUE or FALSE* Teen Activities: If the above is not true and you answered FALSE, please explain full. (Please include all details pertaining to the situation including dates and final outcome.)*
AN ANSWER OF “FALSE” MAY NOT NECESSARILY LEAD TO DISQUALIFICATION. HOWEVER, IT IS IMPORTANT THAT LICENSEE AND MISS UNIVERSE ARE AWARE OF SUCH INFORMATION. YOUR FAILURE TO ANSWER TRUTHFULLY MAY LEAD TO DISQUALIFICATION EVEN IF THE UNDISCLOSED INFORMATION WOULD NOT OTHERWISE HAVE RESULTED IN DISQUALIFICATION HAD THE APPLICANT ANSWERED TRUTHFULLY.
I will be at least 18 years old before January 1, 2024* If you will be under the age of eighteen by January 1, 2024, you are not eligible to compete for the Miss division.
Because you answered False it is our understanding that you will be under the age of eighteen on January 1, 2024, which means that you will not meet the minimum age requirement to enter the pageant for the MISS division. Please be sure to fill out the correct agreement. If you feel like you have reached this message in error, please contact Pageant Headquarters at info@missnewjerseyusa.com
Residency Please select either 1(e)(1), 1(e)(2)(a) or 1(e)(2)(b)* Residency: If none are applicable, please explain:*
Other Contracts (f) I acknowledge that prior to the date of the State Pageant, I did not compete in another state’s pageant preliminary to the 2024 Miss USA Pageant for a period of at least ninety (90) consecutive days before the date of the State Pageant, unless I qualified to compete in another state’s pageant pursuant to Paragraph 1(e)(2) above. I further understand and agree that I may not compete in more than two (2) state pageants preliminary to the 2024 Miss USA Pageant.
Other Contracts: Is the foregoing statement TRUE or FALSE* Other Contracts: If the above is not true, & you answered FALSE, please explain*
(1) I have not authorized or permitted the use of my name, sobriquet, voice, image, likeness (actual or simulated), signature (or facsimile thereof), photographs, caricature, social media handles, persona, nickname, distinctive appearance, gestures/mannerisms, initials and authorized biographical materials in connection with any product or commercial enterprise given any written, verbal or other endorsement of any product, service or commercial enterprise, or entered into any written or verbal agreement with any individual, corporation or organization, which in any way covers, relates to or conflicts with my actions to be performed if I am required by Miss Universe to participate or compete in the 2024 Miss USA Pageant or any events at the site of the 2024 Miss USA Pageant (“Host City”) or elsewhere related to the 2024 Miss USA Pageant
Other Contracts 2: Please select either 1(j)(1) or 1(j)(2)* If you select 1(j)(2), then please provide copies of any such contract, agreement, or endorsement.*
If neither Paragraph applies, please explain so that eligibility can be determined*
Employment Conflicts Employment Conflicts: Is the foregoing statement TRUE or FALSE* Employment Conflicts: If above is not true, and you answered FALSE, please complete the following so eligibility can be determined:*
I understand that any such employment or relationship(s) may affect my eligibility for the State Pageant and, if I win the State Pageant, the 2024 Miss USA Pageant. If any of the foregoing conditions changes before or during competition at the State Pageant, I will immediately give you notice of this fact so that you can make a determination as to my eligibility in your sole judgment. In addition, I acknowledge and agree that (i) you may, in your sole judgment, render eligible or ineligible, as the case may be, any person with such employment or relationship(s) and (ii) you may, in you sole judgment, render ineligible any person who, in your sole judgment, is sufficiently acquainted with any person or entity connected with the production, administration, or judging of the State Pageant or the Miss USA Pageant such that her participation in the State Pageant could create the appearance of impropriety.
Appearances I have NEVER appeared on any television contest, game, competition, or reality show or applied to be a contestant or participant on any television, contest, game, competition or reality show and I have NEVER appeared, or agreed to appear in any other television show or motion picture, online show or the like.
Appearances: Is the foregoing statement TRUE or FALSE* Appearances: If the above is not true, and you answered FALSE, please complete the following so eligibility can be determined:*
I understand that any such appearances or applications may affect my eligibility for the State Pageant and, if I win the State Pageant, the 2024 Miss USA Pageant. If any of the foregoing conditions changes before or during competition at the State Pageant, I will immediately give you notice of this fact so that you can make a determination as to my eligibility in your sole judgment.
Activities a) I represent that at all times prior to the date of this Agreement, I have conducted my activities and life in accordance with the highest ethical and moral standards and that I have never been arrested or charged with the commission of a crime (including, without limitation, reckless or drunk driving or minor in possession of alcohol or illegal possession or use of drugs ) or engaged in any activities that might bring myself, you, Miss USA, the State Pageant, the Miss USA Pageant, the Miss USA Pageant system, the Parties, or any of their respective subsidiaries, affiliated or related companies, officers, directors, partners, shareholders or employees into public disrepute, ridicule, contempt or scandal or might otherwise reflect unfavorably upon any of the foregoing individuals or entities or might shock, insult or offend the community or any class or group thereof. I acknowledge that, by way of example, and without limiting the generality of the foregoing in any way, having appeared in public or permitted myself to be photographed in a state of partial or total nudity or in a lewd, compromising or sexually suggestive manner constitutes a violation of this provision (this includes photographs, images or videos that may appear on any web site or social media platform, such as Instagram, Facebook or
YouTube or that may be recorded or captured privately [and is distributed to any other person or entity).
Activities: Is the foregoing statement TRUE or FALSE* Activities: If the above is not true and you have answered FALSE, please explain in full: (Please include all details pertaining to the situation including dates and final outcome.*
AN ANSWER OF “FALSE” MAY NOT NECESSARILY LEAD TO DISQUALIFICATION. HOWEVER, IT IS IMPORTANT THAT FRANCHISEE AND MISS USA ARE AWARE OF SUCH INFORMATION. YOUR FAILURE TO ANSWER TRUTHFULLY MAY LEAD TO DISQUALIFICATION EVEN IF THE UNDISCLOSED INFORMATION WOULD NOT OTHERWISE HAVE RESULTED IN DISQUALIFICATION HAD THE APPLICANT ANSWERED TRUTHFULLY.
