APPLICATION FOR MISS GAY PRIDE 2004
Legal Name: _______________________________________
Stage Name: _______________________________________
Address: _______________________________________
City _______________________________________
State: _______________________________________
ZIP: _______________________________________
Titles (Prev or Current): _______________________________________

_______________________________________

Sponsors: _______________________________________
Title Of Number: _______________________________________
Persons In Act: (Number)_______________________________
Props Used: Yes        No
I do hereby release APB Productions, Backstreet Memphis and it’s employee’s from any
liability whatsoever resulting from, associated with, and arising out of my participation
in the Miss Gay Pride Pageant, including but not limited to personal property regardless
of whether the loss or injury occurs before, during, or after the pageant or any related
activities. I hereby agree that my name or any photographs, recordings, taken during the pageant may be used for publication or promotional purposes or in any advertised publicity.

By my signature below, I agree that I have read the rules and regulations and will abide
By the same.

________________________________
Signature (legal)

________________________________
Date

Entry fee of $100.00 is due no later than Midnight May 30th. 

Print, complete, and bring application and fee to Byron @ Backstreet during business hours.  For more information, call Byron at 901-359-1190.