2007 Universe Weekend

* Denotes a Required Field

Contestant Information
*	Event(s)	Model Universe Championships Ms. Bikini Universe Fitness Universe Pageant Musclemania Universe Championships Figure Universe Championships Annual Membership Fee
*	Legal Name
	Nickname (Stage Name)
	Team/Sponsor Name
*	Address Line 1
	Address Line 2
*	City
*	State/Province
*	Country
*	Zip or Postal Code
	Day Phone
*	Night Phone
*	E-Mail Address
*	Age
*	Date of Birth
*	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
$25 Annual Membership Fee		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. I agree to the terms & conditions above.