ENTRY FORM 
 
The following is the ENTRY FORM for Miss HeartShine USA 2018. By submitting this 
 
ENTRY FORM, along with the two other required documents alongside your entry fee, 
 
the contestant will be entered into the HeartShine National pageant contest to be held 
on the Carnival Cruise Ship Imagination.   6616D Clark RD #200 
  Paradise, CA 95969 
(530) 762-2219 
NAME OF CONTESTANT   
heartshinepageants@
 
gmail.com 
CONTESTANT AGE   
(as of Oct. 21st 2018)   
  SCORING CRITERIA 
FOR ALL REQUIRED SEGMENTS OF 
NAME OF   
PARENT/GUARDIAN    COMPETITION 

 
200 total points 
NAME(S) OF ANY/ALL   
possible  
SUPPORTERS OF     
CONTESTANT ATTENDING   
THE CRUISE    Personal  1-50 
Introduction 
 
Formal Wear  1-50 
MAILING ADDRESS  Address _​ _______________ 
*Required  Address Line 2 ___________________  On-Stage  1-50 
City/State ______________________  Question 
Zip __________________________ 
Community  1-50 
  Dedication 
CELL PHONE    
We WILL call or text you with updates   
while on board! 
POINTS WILL BE 
 
  DEDUCTED FOR 
EMAIL ​*Required     
● Excessive tardiness to the 
 
any segment of required 
 
competition 
LIST OF ALL SPONSORS    ● Inappropriate behavior 
● CAN USE THE BACK  such as foul language 
OR ATTACH PAGES IF 
● Unsportsmanship 
NEEDED  
● CAN BE DUPLICATED  behavior 
IF SPONSOR IS  ● Excessive tardiness or 
ALREADY A ‘SPIRIT  absenteeism to the White 
QUEEN’ or T-SHIRT  Diamond Photo Shoot  
SUPPORTER  ● Excessive display of a lack 
● YOU CAN LIST  of humility, a display of 
INDIVIDUALS  
bullying, or other 
● YOU CAN SIMPLY 
PUT “FAMILY AND  unacceptable behavior 
FRIENDS” OR THE  ● Turning off the mic 
NAME OF YOUR  ● Misrepresenting 
FAMILY’S BUSINES​S  HeartShine on the ship or 
  beyond 
 
Submit form via Email or Mail, or,    
turn in at Registration  
 
SIGNATURE FORM FORM 
 
The following is the SIGNATURE FORM for Miss HeartShine USA 2018.   
By submitting this SIGNATURE FORM, along with the two other   
required documents alongside your entry fee, the contestant will be  6616D Clark RD #200 
entered into the HeartShine National pageant contest to be held on  Paradise, CA 95969 
the Carnival Cruise Ship Imagination.   (530) 762-2219 
 
heartshinepageants@
NAME OF CONTESTANT    gmail.com 
 
1. All applicants, their parent(s)/guardian(s), and supporters agree to adhere to HeartShine’s Code of   
Conduct for pageant events. There is a zero tolerance policy for unsportsmanship behavior and  HEARTSHINE MISSION 
bullying. THIS RULE EXTENDS TO YOURSELF, be kind to yourself throughout the HeartShine 
STATEMENT 
pageant process and celebrate your bravery, commitment, and kind heart. To participate in a 
HeartShine pageant is to agree to contribute to HeartShine’s reputation of “Positive Pageantry.” 
2. You and your child’s privacy is important. HeartShine never gives your personal information to a  HeartShine is an ‘inner-beauty’ 
third party and doesn’t share emails and information. 
pageant system that has unique 
3. Applicant and their parent(s)/guardian(s) agree that all fees, including Optional entry fees, Entry 
fees, and other pageant expenses are non-refundable. If you are unable to make the cruise you will  scoring criteria that judges the 
not be reimbursed.  
4. Applicant and their parent(s)/guardian(s) agrees that the 4 overall segments of competition will be  contestant on what truly matters. 
scored based on criteria such as inner-beauty, public speaking skills, and civic-mindedness. There is 
no beauty-standard judging, though poise and an effort toward a clean, professional or put-together 
HeartShine empowers titleholders, 
image is an important part of feeling confident and showcasing your HeartShine. Age categories are  developing confidence, life-skills, 
subject to change. 
5. Applicant and their parent(s)/guardian(s) agree that failure to comply with these terms shall, at  and community-mindedness, while 
the option of the pageant, result in the disqualification of the contestant.  
6. Applicant and their parent(s)/guardian(s) agree that any and all pictures, videos, and audio taken  providing opportunities for 
at the pageant are the property of HeartShine and may be used for promotional purposes without  leadership, volunteerism, 
compensation. This includes but is not limited to social media, print, and broadcast media.  
7. Applicant and their parent(s)/guardian(s) agrees that all paperwork, logos, online print  scholarship potential, and positive 
promotions, and contestant resources are property of HeartShine - this includes HeartShine titles, 
procedures, and trade dress.   sisterhood. 
8. HeartShine is not responsible for lost, stolen, or damaged property on or around nationals nor 
AN OVERVIEW OF WHAT’S 
following appearance and service events.  
9. All judges decisions are final. You may request your scores and comments after the pageant by  IN THE AGREEMENT (LEFT) 
emailing heartshinepageants@gmail.com and pay $15 via PayPal to the same address - allow 2-3 
weeks for delivery.   Sportsmanship, sisterhood, and 
10. Applicant, their parent(s) and guardian(s), and their family and supporters agree to adhere to any 
and all additional rules Carnival Cruise has established for the trip.  good sportsmanship behavior is 
11. Applicant must be of good moral character and never convicted of a crime.  
12. Applicant and their parent/guardian agrees to abide by all rules and regulations now in effect and 
required of everyone. In order for 
any new rules mandated in their future or their titles and any/all awards are subject to become void  queens to qualify for a scholarship 
(including scholarship potential and ability to return to crown successor).  
13. Applicant and their parent/guardian agrees that they will forfeit any and all awards if they are  at the end of their reign, certain 
found misrepresenting Heartshine in any way.  
14. In order to receive a scholarship at the end of their reign, a HeartShine National Queen will have  year’s requirements must be met. 
needed to have participated in at least THREE community service/appearance/photo shoot event a  Some volunteer and appearance 
month, every month, until the next HeartShine national event. Exceptions may be made but 
ongoing communication with directors about community service/appearance/photoshoot  events are pre-approved but others 
participation is needed in order to not put your scholarship at risk.  
15. HeartShine national queens are expected to return the following National pageant to crown their  are not. HeartShine is not an 
successor, volunteer at the pageant event, and perform other outgoing duties.   exclusive system, but events where 
 
  HeartShine is represented you 
I agree to the rules and regulations of Miss HeartShine USA 2018.  must attend in HeartShine title or 
  not at all. There will be many 
Contestant Signature: ____________________ Date: ______ 
  opportunities to increase your 
Parent/Guardian Signature: ________________ Date: _______ 
(if contestant is under 18)  scholarship amount through 
community support and 
sponsorship packages.   
  

EMCEE CARD 
Emcee Card contents (in partial or in full) will be read during Formal Wear competition 
by the emcee. The contents of the Emcee Card will not be scored. 
 
   
NAME OF CONTESTANT    6616D Clark RD #200 
  Paradise, CA 95969 
(530) 762-2219 
CONTESTANT AGE   
(as of Oct. 21st 2018)  heartshinepageants@
  gmail.com 
NAME(S) OF UP TO THREE     
SPONSORS     
 
  PHONETIC PRONUNCIATION 
 
OF NAME 

WHAT IS YOUR PLATFORM     

 
 

   
DESCRIPTION OF FORMAL 
WEAR GOWN   

  SPECIAL 
  ASSISTANCE/ADAPTATION 
GOAL FOR THE FUTURE 
NEEDED (IF ANY) 
 

HOW A FRIEND MIGHT     

   
DESCRIBE YOU   
 
 
   
   
 
   
______________________________________________ __________________ 
   
 
 

COMMUNITY DEDICATION 
   
I hereby certify that I (the contestant) has participated in a   
community service project within the past 6 months. I have described the  6616D Clark RD #200 
community service event in the space provided below.  Paradise, CA 95969 
  (530) 762-2219 
____________________________ heartshinepageants@
____________________________ gmail.com 
____________________________  
Full credit (full 50 points) if you 
____________________________
turn a completed Community 
____________________________ Education certification form.  
____________________________  

____________________________ HeartShine Queens represent their 

____________________________  community with pride and participate in 

  volunteer service events throughout 

Name: _________ Signature: ____________  their reign.