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CONTESTANT INFORMATION
Event(s) - Select all that apply:
Model America Championships
Ms. Bikini America
Figure America Championships
Fitness America Pageant
Musclemania America & World Championships
Legal Name
Nickname or Stage Name
Team/Sponsor Name
Address Line 1
Address Line 2
City
State or Province
Country
Albania
Algeria
Argentina
Australia
Austria
Bahrain
Belarus
Belgium
Bolivia
Bosnia and Herzegovina
Brazil
Bulgaria
Canada
Chile
China
Colombia
Costa Rica
Croatia
Cyprus
Czech Republic
Denmark
Dominican Republic
Ecuador
Egypt
El Salvador
Estonia
Finland
France
Germany
Greece
Guatemala
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iraq
Ireland
Israel
Italy
Japan
Jordan
Kuwait
Latvia
Lebanon
Libya
Lithuania
Luxembourg
Macedonia
Malaysia
Malta
Mexico
Montenegro
Morocco
Netherlands
New Zealand
Nicaragua
Norway
Oman
Panama
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Saudi Arabia
Serbia
Serbia and Montenegro
Singapore
Slovakia
Slovenia
South Africa
South Korea
Spain
Sudan
Sweden
Switzerland
Syria
Taiwan
Thailand
Tunisia
Turkey
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Venezuela
Vietnam
Yemen
Zip or Postal Code
E-Mail Address
Day Phone
Night Phone
Age
Date of Birth
Month
January
February
March
April
May
June
July
August
September
October
November
December
Day
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01
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30
Year
1900
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1910
1911
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1914
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2000
2001
2002
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2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
Height
Competition Weight
BIOGRAPHICAL INFORMATION
(All Competition Divisions)
Education Level & Academic Background
Occupation
Fitness or Sports Competition Experience
Other Interesting Information About Yourself
Family Background
Ambitions
Modeling Experience
Why You Should Win The Universe
Have You Ever Competed At Universe Weekend
Yes
No
$25 Annual Membership Fee (must be paid once each year)
Yes
I certify that I am in mentally sound and physically healthy, have sufficiently trained for participation in the event and have not been advised otherwise by a qualified medical person. I acknowledge that this Accident Waiver and Release of Liability form will be used by the event holders, sponsors and organizers, in which I may participate and that it will govern my actions and responsibilities at said events. In consideration of my application and permitting me to participate in this event, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: (A) Waive, Release and Discharge from any and all liability for my death, disability, personal injury, property damage, property theft or actions of any kind which may hereafter accrue to me including my traveling to and from this event, the Fitness Universe, Inc., and their directors, officers, employees, volunteers, representatives, and agents, the event holders, event sponsors, event directors, event volunteers; (B) Indemnify and Hold Harmless the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this event, whether caused by the negligence of releases or otherwise. I hereby consent to receive medical treatment, which may be deemed advisable in the event of injury, accident and or illness during this event. This Accident Waiver and Release of Liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. And, in further consideration of permission being granted to me to participate in the Fitness Universe Pageant, Ms. Bikini Universe, Figure Universe Championships, Musclemania Universe Championships, Model Universe Championship, Clash Hip Hop Universe Championships and/or Universe Crew Championships and their related events (the "Event"), receipt of which benefit is hereby acknowledge, I hereby grant you, Fitness Universe, Inc., Inc., Physical Management, Inc. and any and all approved video or entertainment organizations, and all of their agents, successors, licenses and assigns, the right to photograph or otherwise reproduce (whether by film, tape, still photography or otherwise) my voice, appearance and name, and to exhibit, distribute, transmit, and/or exploit any and all such reproductions containing my voice and/or appearance in any and all media, including without limitation, by means of still photography, motion pictures, video, printing or any other media now known or hereafter devised, including also with respect to merchandising, advertising and/or publicity, and the right to use my name and information about me in any connection with the foregoing. The rights granted by me hereunder are granted for the entire universe and shall endure in perpetuity, and no further compensation shall be payable to me at any time in connection therewith. Nothing contained herein shall be deemed to obligate you, Fitness Universe, Inc., approved video or entertainment organizations, to photography or otherwise reproduce my voice, appearance or name, or to make use of any of the rights granted herein. These rights may be assigned by Fitness Universe, Inc., at their sole and complete discretion. I understand that you, Fitness Universe, Inc., Physical Management, Inc., approved video or entertainment organizations are videotaping and photographing the event in express reliance upon the foregoing, and I represent and agree that I am free to grant the rights granted to you, Fitness Universe, Inc., Physical Management, Inc., and any and all approved video entertainment organizations hereunder.
Terms & Conditions
I Agree
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