Photogenic (Ages 1 Week to 19 Years)

Contestant Name

Contestant Age

Contestant Date of Birth (MM/DD/YY)

Photo Upload (5x7 Headshot Only)

Parents Name

Phone Number

Cell Phone

By checking this box you agree that you have read and understand the rules outlined in the registration form.

Photogenic Registration

Please include full information at checkout if paying registration fee online.

Completed form and 5x7 photo can be mailed to or turned in at the following location:

Home Printing Company

505 Second Ave. South

Clanton, AL 35045