®
®
State Pageant for Miss USA & Miss Teen USA , Independently Produced by Top 10 Productions, Inc under contract from Miss Universe L.P.,LLLP.
Congratulations!
Based on your preliminary interview you have been accepted and are now officially part
of a select group of exceptional young women chosen to participate in the 2014 Miss
California USA® or Miss California Teen USA® Pageant. Your involvement also provides
you the chance to be awarded the crown and go on to represent California at the
national MISS USA® PAGEANT or MISS TEEN USA® PAGEANT. We are so excited to
have you as part of this experience and we know that you will represent your community,
friends and family with the same beauty, style, intelligence and uniqueness which we
recognized in you during the interview process. In just a few months you will also be
standing center stage, spending the time of your life, with like-minded young women.
Previous contestants say that they attribute much of their success to the empowerment
they received from being surrounded by so many bright, beautiful, and driven young
women and through the experience of the state pageant.
The contestant entry fee of $1,750.00 includes everything you will need during pageant
weekend. From the time you check in all your meals, your hotel room, rehearsals,
production fees, hair and makeup stylists, on staff medics, chaperones, up until your
departure. It also includes your photo taken for the program book, entry for you and your
family to scheduled sessions with industry professionals and sponsors at our official
orientation. You may pay by check, credit card (cc pymts can be taken over the phone)
or money order.
Entry fees can be paid by you, a family member, or on your behalf, through single or
multiple sponsors that you secure. Feel free to contact us if you wish to participate and
need ideas to help finance your entry.
Make payments payable to:
Mail Payments to:
Miss Universe Organization
Top 10 Productions, Inc.
6101 Lake Murray Blvd. #213
La Mesa, California 91942
More information can be found on our website www.MissCaliforniaUSA.com. If you can’t
find an answer to your questions you or anyone else supporting your participation can
call us during the hours of 9 a.m. to 5 p.m. Monday through Friday at our production
office, 619.698.4045. We will be happy to help.
Welcome to the Miss California USA Family!
Pam Wilson & Alex Kuty
2014 State Pageant Producers
®
®
State Pageant for Miss USA & Miss Teen USA , Independently Produced by Top 10 Productions, Inc under contract from Miss Universe L.P.,LLLP.
2014 DOCUMENT CHECKLIST
Participant’s First & Last Name:
Teen or Miss Contestant?
In order to confirm your spot in the 2014 state pageant, please complete and return all
contents of this packet, plus photocopies of your birth certificate and proof of residency
documents along with your deposit. Parent/Guardian signatures are required only if you
are under 18 years old on the date you enter your signature.
Please send this form as a coversheet to all forms.
1. Pageant Eligibility Form
2. Contestant Registration Form
3. Fees Disclosure
4. Entry Fee Form, Along with Deposit/Payment
5. Release of Liability
6. Titleholder Management Agreement
7. Overnight Stay Agreement
8. Health Form
9. Copy of your Birth Certificate/Age Documentation
10. Proof of Residency Forms
11. State Pageant Contract
Items 12-15 may be turned in before November 1, 2013 and once your title is
confirmed…..
12. Name Pronunciation Form
13. Swimsuit Script for MC
14. Evening Gown Script for MC
15. Judges Information Sheet
Please mail your completed paperwork and $875.00 deposit to:
Top 10 Productions, Inc.
6101 Lake Murray Blvd. #213
La Mesa, California 91942
Make payments payable to: Miss Universe Organization
®
®
State Pageant for Miss USA & Miss Teen USA , Independently Produced by Top 10 Productions, Inc under contract from Miss Universe L.P.,LLLP.
1. 2014 PAGEANT ELIGIBILITY
Before proceeding with this packet please take a moment to verify that you are eligible to participate….
One of the following statements is true:
2014 MISS CALIFORNIA USA Contestants:
Must be at least 18 and under 27 years of age as of February 1, 2014
2014 MISS CALIFORNIA TEEN USA Contestants:
Must be at least 14 and under 19 years of age as of February 1, 2014
At least one of the following statements is true (circle or bold which one).
a) I now reside in California as my permanent and primary residence and have been living in California
for a period of at least six (6) months immediately prior to the beginning of the California pageant
(although you may have attended college or University elsewhere);
OR
b) I have resided in California as a full-time student at a college or university for one entire semester
immediately prior to the beginning of the California state pageant, and I am continuing to reside in
California as a full-time student (although you may have spent or be spending the summer in another
state).

Documentation must be provided to prove citizenship and residency
The following statements must be true:
I am a female citizen (recognized medically and legally) of the United States and will be able to provide
either a US Birth Certificate or Naturalization Papers.
I am not married, never have been married, and never have had a marriage annulled.
I am not pregnant and have never given birth to a child.
I have never had semi-nude or nude photos or footage taken of me.
I understand there are more specific eligibility requirements outlined in the state pageant contract, item #11
of this packet, and I will carefully review them to confirm my eligibility.
Participant’s Signature:
Date
Print Name:
Parent/Guardian Signature (if under 18):
Date
Print Name:
®
®
State Pageant for Miss USA & Miss Teen USA , Independently Produced by Top 10 Productions, Inc under contract from Miss Universe L.P.,LLLP.
2. 2014 CONTESTANT REGISTRATION FORM
Full Name:
Birth Date:
Email Address:
Contestant registering for… (Check one)
2014 MISS CALIFORNIA USA® or
2014 MISS CALIFORNIA TEEN USA®
Best Contact Phone Number:
Alternate Phone:
CA Driver’s License Number (If Applicable):
Address:
City:
State:
Zip:
County:
Please REQUEST what area you would like to represent in the state pageant. Please give at least 3
options. Examples include “Hollywood,” “Sun Valley,” “South Sacramento.” We will contact you to let you
know what area has been assigned to you. If you are currently holding a title from a preliminary pageant,
please specify. If you have not won a title in a local or preliminary pageant, you have no right to use
“MISS” as it is not part of your title. For instance, you will not say that you are MISS ORANGE
COUNTY but ORANGE COUNTY.
1:
2:
3:
Returning Contestants Only:
Did you compete in the 2013 Pageant?
What was your area of representation?
Did you place in top 5, 10 or 20?
Have you competed in a past Miss CA USA pageant other than 2013?
The following discounts would apply to returning contestants:
$400 Off Top 5 if you placed in the 2013 pageant, $300 Off Top 10 if you placed in the 2013 pageant
$200 Off Top 20 if you placed in the 2013 pageant, $100 Off All returning 2013 Contestants.
New Contestants Only:
If you have a recruiter please state your recruiter’s name:
Participant’s Signature:
Date
Print Name:
Parent/Guardian Signature (if under 18):
Date
Print Name:
®
®
State Pageant for Miss USA & Miss Teen USA , Independently Produced by Top 10 Productions, Inc under contract from Miss Universe L.P.,LLLP.
3. 2014 FEES DISCLOSURE
The entry fee for the 2014 MISS CALIFORNIA USA® or 2014 MISS CALIFORNIA TEEN
USA® Pageant is $1,750.00 per contestant. I,
hereby acknowledge that an $875.00 deposit is nonrefundable and will not be returned to me under any circumstances based on the fact
that I have confirmed that I meet the eligibility requirements to participate (please read
full eligibility requirements in the state pageant contract item #11 of this packet).
Furthermore, should I decide not to participate, I understand any monies accrued above
and beyond the $875.00 non-refundable deposit will be refunded to me at 50% if I notify
Top 10 Productions, Inc. 90 days or more prior to check-in for pageant weekend. Should
I notify Top 10 Productions, Inc. of my withdrawal 30 to 89 days prior to check-in for
event weekend, 20% of any monies accrued above and beyond the $875.00 nonrefundable deposit will be refunded to me. Should I decide not to participate and notify
Top 10 Productions, Inc. 29 days or sooner to check-in for event weekend, no monies
will be refunded to me.
If, and only if, Top 10 Productions, Inc. determines I am ineligible to participate in the
2014 MISS CALIFORNIA USA® or 2014 MISS CALIFORNIA TEEN USA® Pageant
because of Top 10’s oversight of facts disclosed in writing at the time of signing this form
and you provide a receipt of same, total fees, including the $875.00 deposit, will be
returned to me. No exceptions will be made to the aforementioned disclosure under any
circumstance.
The following discounts will apply to returning contestants: $400 Off Top 5 if you placed
in the 2013 pageant, $300 Off Top 10 if you placed in the 2013 pageant, $200 Off Top
20 if you placed in the 2013 pageant, $100 Off All returning 2013 Contestants.
By signing this form I acknowledge that I will not be considered a registered contestant
until the entry fee has been paid in full. Failure to do so by Nov. 1, 2013 will result in
suspension of my account and forfeiture of my title.
All checks will be made payable to: Miss Universe Organization
Participant’s Signature:
Date
Print Name:
Parent/Guardian Signature (if under 18):
Date
Print Name:
®
®
State Pageant for Miss USA & Miss Teen USA , Independently Produced by Top 10 Productions, Inc under contract from Miss Universe L.P.,LLLP.
4. 2014 ENTRY FEE FORM
When you turn in payments for your entry fee please include this form with your payment
and keep a copy for your records.
Contestant Name:
Date:
Email Address:
Phone:
Deposit amount of $875 must be submitted to Top 10 Productions, Inc in order to reserve your spot in the
competition. Turning in the deposit will only tentatively hold your title. The Balance of $875 is due on or before
November 1, 2013. Full entry fee will confirm your spot and your title.
I am paying via…..
Money Order
Amount $
Money Order Dated
Check#
Amount $
Check Dated
Make checks payable to Miss Universe Organization
Credit Card
Card Type:
Amount to charge $
VISA
Charge Date
Master Card
American Express
Name as it appears on Card
Amount to Charge $
Card#
Exp
Card Holder’s Signature
CV2
Date:
Participant’s Signature:
Date
Print Name:
Parent/Guardian Signature (if under 18):
Date
Print Name:
Recruiter Name (if applicable):
ALL DEPOSITS ARE NON-REFUNDABLE!!! Please refer to the Fees Disclosure Form.
®
®
State Pageant for Miss USA & Miss Teen USA , Independently Produced by Top 10 Productions, Inc under contract from Miss Universe L.P.,LLLP.
5. 2014 RELEASE OF LIABILITY
Disclosure: Please read carefully before signing!
Top 10 Productions, Inc.
State Pageant Contractor
Participant’s Name:
In consideration of participation in the MISS USA® or the MISS TEEN USA® State
Pageant and its related events and activities produced by the contractor listed above, I
agree that:
1. There are inherent risks of injury.
2. I am assuming those risks.
3. For all injuries I might sustain, I indemnify and hold harmless the MISS UNIVERSE
Organization and the above named state pageants, the sponsoring contractor, and all
representatives, employees, subcontractors, and volunteers of that contractor.
I (we) have read this release of liability and assumption of risk agreement, fully
understand its terms and sign it voluntarily.
Participant’s Signature:
Date
Print Name:
Parent/Guardian Signature (if under 18):
Date
Print Name:
®
®
State Pageant for Miss USA & Miss Teen USA , Independently Produced by Top 10 Productions, Inc under contract from Miss Universe L.P.,LLLP.
6. 2014 TITLEHOLDER MANAGEMENT AGREEMENT
As a delegate to the MISS USA® or the MISS TEEN USA® State Pageant,
I,
(contestant name),
understand I may be selected for either applicable title, and I agree to the following
conditions:
1. The winners of both pageants (2014 “Titleholders”) will be managed solely by Top 10
Productions, Inc. for civic and philanthropic appearances, and for commercial, print,
theatrical, hosting and reality contracts or engagements for the period of time beginning
with the crowning through the finals show date(s) of the 2015 MISS USA® Pageant
and/or the 2015 MISS TEEN USA® State Pageant.
2. I will not promote my likeness, name, or title for any product, service, or event at any
time during the approximate twelve months of the reign(s) referenced in Paragraph 1
without prior written approval of Top 10 Productions, Inc.
3. I will not contract for any commercial endorsement or guest appearance at any time
during the approximate twelve months of the reign(s) referenced in Paragraph 1 without
prior written approval of Top 10 Productions, Inc.
4. I will not sign an exclusive contract with any agency during the approximate twelve
months of the reign(s), without prior written approval of Top 10 Productions, Inc.
5. I am now represented by
my
(non-exclusive)
(exclusive) licensed agent.
(agency) as
6. If I win either applicable national title, I accept that this Agreement will become null
and void immediately and I will thenceforth be managed solely by the MISS UNIVERSE®
Organization.
Participant’s Signature:
Date
Print Name:
Parent/Guardian Signature (if under 18):
Date
Print Name:
®
®
State Pageant for Miss USA & Miss Teen USA , Independently Produced by Top 10 Productions, Inc under contract from Miss Universe L.P.,LLLP.
7. 2014 OVERNIGHT STAY AGREEMENT
In connection with my participation in the 2014 State Pageant, the 2014 State Pageant
(the “Pageant”) may cause others (the “Hotel”) to make available to me overnight lodging
(the “lodging”) as such location or locations as the Pageant may from time to time
designate. I agree that the Pageant shall not be liable for any cost or expense in
connection with the lodging, other than the base room price and taxes thereon.
Accordingly, I agree to be responsible for and to immediately pay to the Pageant or, at
the request of the Pageant, the hotel, any other room charges including, without
limitation, telephone, in –room movies, bottled water, valet, room services, food and
beverage, damage, and any other additional services billed to my room.
I understand that I will be required to place a cash deposit of $50.00 US or leave a credit
card imprint as payment guarantee with the Hotel.
I understand that my room account must reflect a balance of $0.00 (zero balance) before
my departure to the finals area on the last morning of the last day of my stay with the
Pageant.
I agree to be bound by and observe all rules and regulations of the hotel and of the
Pageant, in connection with lodging. I agree to share my room at the hotel with other
Pageant contestant.
I further agree that the Pageant shall not be responsible for any damage or loss to my
property while at the hotel, theater, or any other pageant related location, whether
caused by casualty, theft, or any intentional act or omission by any third party, including
without limitation vendor or pageant staff. I further agree to vacate the hotel at such time
as is designated by the Pageant, and/or to be responsible for any excess charges as a
result of my failure to vacate, and to remove all my belongings by said time. I further
agree that the pageant shall not be liable for any injury to my person while at or traveling
to and from the hotel.
Participant’s Signature:
Date
Print Name:
Parent/Guardian Signature (if under 18):
Date
Print Name:
®
®
State Pageant for Miss USA & Miss Teen USA , Independently Produced by Top 10 Productions, Inc under contract from Miss Universe L.P.,LLLP.
8. 2014 HEALTH FORM
Please complete this form accurately. The information is necessary so that our staff may
assure you maximum comfort and security.
Full Name:
Birth date:
Age:
Address:
Phone Number:
Alternate Phone:
Emergency Contact Name:
Phone:
Relationship:
Current Physician:
Phone Number:
List medications which may cause serious reactions:
List impairments applicable to you:
List current medications:
Food/Environment allergies:
Insurance Carrier:
Phone Number:
Address:
Policy#:
Type or Group#:
Name of Insured or Insuring Employer (family policies):
Do you Wear Dentures or Partial Pacemaker, Contact Lenses?
Prosthetic Aid, Hearing Aid, Experience Seizure or Fainting?
IF NOT INSURED, PLEASE SIGN BELOW TO ACCEPT ALL FINANCIAL REPONSIBILITY FOR ANY
MEDICAL CARE NEEDED DURING PAGEANT WEEKEND:
Participant’s Signature:
Date
Print Name:
Parent/Guardian Signature (if under 18):
Date
Print Name:
No pageant staff will be allowed to dispense medical advice or medication to ANYONE during the pageant weekend.
®
®
State Pageant for Miss USA & Miss Teen USA , Independently Produced by Top 10 Productions, Inc under contract from Miss Universe L.P.,LLLP.
9. 2014 AGE DOCUMENTATION
There are several personal documents required in order for you to participate in the 2014 State Pageant.
One document will show proof of your age and two documents showing proof of residency. Do not submit
your paperwork without attaching these documents to the official forms packet!
All contestants must submit a photocopy of their birth certificate, even if you have participated in prior
years’ competitions. Attach a photocopy of your Birth Certificate to the back of the Official forms Packet. It
does not need to be a certificated or notarized copy. We cannot accept any other document for this
requirement.
If you were not born in the United States, you must also attach a photocopy of your passport or
naturalization papers, in addition to your birth certificate, establishing that you are a citizen of the United
States. Passports and citizenship papers are not acceptable as proof of state residency documents.
®
®
State Pageant for Miss USA & Miss Teen USA , Independently Produced by Top 10 Productions, Inc under contract from Miss Universe L.P.,LLLP.
10. 2014 PROOF OF RESIDENCY
In addition to a birth Certificate, proof of residency documents are required showing that you have resided
in the State for the full 6 months period prior to the pageant date. The dates listed on these documents
(such as date of issue, statement date, invoice date, etc…) must have one dated a full 6 months prior and
one dated currently.
If you will be 15 yrs or younger January 1, 2014, you are required to send in proof of residency in the form
of two school records (one dated currently and one dated before July 2, 2013, and your name and
address must be on the document.) No other proof of residency can be accepted.
Acceptable School Records are: (Submit 2, each dated accordingly)
Grade Report Card, Class Schedule, Official Transcript, Tuition or Supply Invoice, or A letter from the
school’s office confirming your name, address and the date you enrolled at the school.
Note: School Photo ID Cards are only accepted if your name and address and school year are all shown.
If you will be 16 yrs old or older on January 1, 2014, you will either submit two (2) or three (3) documents
depending on what items you choose from the sections below. They must have your name and address on
them and show a correct date.
Option1: Submit two (2) documents from Column A: one dated before July 2, 2013 and one from the
current month.
Option 2: Submit one (1) document from Column A and two (2) from Column B. The 2 items from Column
B must be dated accordingly – one from the current month, and one before July 2, 2013 and must
accompany one from Column A.
Column A: At least one document is Required
from this column.
State driver’s license/permit
Voter ID or registration card
Income State Tax return - last year
School Record
State issued ID card
Lease/deed for a dwelling
Payroll Stub or W2
Column B: One (1) dated before July 2, 2013
and One (1) from the current month
Automobile Registration
Telephone or cell phone bill
Electric/Water Bill
Medical/Dentist Bill
Bank or credit card statement
Not Accepted: Passports and Social Security Cards and not accepted as proof of residency documents,
nor are envelopes addressed to you, copies of blank checks from your checking account, items mailed to
you from the pageant office, documents in your parents name that do not list your name or any other
document that does not show your name and address and a correct date as described above.
The documents you submit must show your name and a California address even if it is not your
current address. Any sensitive information such as card numbers, account balances may be
crossed out.
®
®
State Pageant for Miss USA & Miss Teen USA , Independently Produced by Top 10 Productions, Inc under contract from Miss Universe L.P.,LLLP.
11. 2014 STATE PAGEANT CONTRACT
In addition to this packet the contestant forms section of MissCaliforniaUSA.com has a contract in
which you must download and complete. There is a contract for the teen contestants and a
separate contract for the miss contestants. Please download the form that applies to you.
Directions for completing Miss/Teen pageant contract are below. Please note there are separate
contracts for the teen and miss contestants but the directions for completing the contract are the
same.
Please make sure to follow all instructions and read each section of the contract carefully. If the form is not
completed correctly you will be required to resubmit it.
At the top of the contract please put “California” as the state title you are competing for.
• ALL PAGES must be initialed at the bottom. If you are under 18 the contestant AND the parent/guardian
must initial.
• ALL True/False questions must be answered. If you check False, please explain in space provided.
Pg 1:
Section 1.
Part (a) Please write Top 10 Productions, Inc in the blank line.
Pg 2:
(g) Please enter your complete birth date
Pg 12
Contestant Signature : All contestants must sign this page
Signature of Parent: ONLY required if you are under 18 years old
Please be sure to initial the bottom
Pg 12/13:
Under “accepted and agreed to” this is for the signature of Top 10 Productions, Inc.
PLEASE LEAVE THESE LINES BLANK but you must initial the bottom!
®
®
State Pageant for Miss USA & Miss Teen USA , Independently Produced by Top 10 Productions, Inc under contract from Miss Universe L.P.,LLLP.
12. 2014 NAME PRONNUCATION FORM
TO BE GIVEN TO THE SHOW PRODUCER/MCs
(1) The pronunciation of my name is:
FIRST
MIDDLE (optional)
LAST
EXAMPLES:
Karin Meyer: CAR’ IN MY’ ER
Karen Brosi: KAREN BRO’ SEE
Tiffany Treboyevich TIFFANY TREH BOY’ EH VITCH
or
TIFFANY TRAY BOY AY’ VICK
Kimberly Gloudemans KIMBERLY GLOUD’ EH MUNS
(rhymes with cloud)
Deana Avila DEENA AH’ VEE LA’
Andrea AN’ DREE A
or
ON DRAY’ A
or
ON’ DREE A
(2) My correct area of representation is:
(3) My recruiter (if applicable) is:
Participant’s Signature:
Date
Print Name:
Parent/Guardian Signature (if under 18):
Date
Print Name:
®
®
State Pageant for Miss USA & Miss Teen USA , Independently Produced by Top 10 Productions, Inc under contract from Miss Universe L.P.,LLLP.
13. 2014 SWIMSUIT SCRIPT FOR MCs
We ask that each contestant submit a “script” about yourself for the MCs to read during
the swimsuit competition of the preliminary show. Please provide TWO sentences about
yourself which totals no more than 15 seconds of speaking. It should be something fun
and light as you are on stage in your swimsuit while it is being said. The content should
be unique to who you are and what is important about you. Please include the phonetic
spelling of your name at title if needed.
Examples:
Pam is a 21-year-old San Francisco Native. She enjoys baking and surfing! Her favorite
food is fish tacos.
Alex Kuty (Koo-Tee) loves cheerleading, dancing and gymnastics. She will be
graduating from High School this Spring.
Name:
Title:
®
®
State Pageant for Miss USA & Miss Teen USA , Independently Produced by Top 10 Productions, Inc under contract from Miss Universe L.P.,LLLP.
14. 2014 EVENING GOWN SCRIPT FOR MCs
We ask that each contestant submit a “script” about yourself for the MCs to read during
the evening competition of the preliminary show. Please provide TWO sentences about
yourself which totals no more than 15 seconds of speaking. It should be informative and
professional as you will be on stage in your gown at this time. The content should be
unique to who you are and what is important about you. Please include the phonetic
spelling of your name at title if needed.
Examples:
Pam Wilson has a 4.0 GPA and is the senior class president. She has been
volunteering with the best buddies program for the past 3 years.
Mabelynn (May-Buh-Lean) Capeluj (Cap-A-Loo) has been a model for GAP and
Nordstrom and is a student at UCLA. She aspires to be a marketing executive while
continuing her modeling career.
Name:
Title:
®
®
State Pageant for Miss USA & Miss Teen USA , Independently Produced by Top 10 Productions, Inc under contract from Miss Universe L.P.,LLLP.
15. 2014 JUDGES INFORMATION SHEET INSTRUCTIONS
Besides the official Miss California USA program book, your judges information sheet will be the
only sheet the judges will receive with your information during the interview. We will not proof
read or make suggestions/changes to your sheet so please double check everything. We
suggest you save a copy for you to review closer to the pageant weekend.
1. Insert the photo you would like the judges to see in the upper right hand photo box.
2. Where is says “Competing for…” omit the title you are not competing for so it reads
“Competing for your title.”
3. Make your answers in regular font and leave the prompts in bolded font.
4. Judges information sheet must fit on ONE page. Feel free to adjust the space as need to
make your content fit.
5. Sign and date the bottom.
6. Please mail 10 copies of your judges info sheet with your paperwork to:
Top 10 Productions, Inc.
6101 Lake Murray Blvd. #213
La Mesa, California 91942
®
®
State Pageant for Miss USA & Miss Teen USA , Independently Produced by Top 10 Productions, Inc under contract from Miss Universe L.P.,LLLP.
15. 2014 JUDGES INFORMATION SHEET
Name:
Competing for Miss California USA OR
Miss California Teen USA?
Insert your photo here
Area of Rep:
Age:
Height:
Hair Color:
Eye Color:
Name of School you currently attend/Grade:
If you are employed, where do you work?
Career Ambition:
Hobbies and Special Talents:
Awards, Scholarships and Honors:
Other interesting information:
What do you love most about California?
Contestant Signature:
Date: