Van Buren County Fair Factor
Entry Form

DEADLINE TO REGISTER: SEPTEMBER 5TH
There will be an Entry Fee of $10.00
WINNER WILL RECEIVE A $500.00 CASH PRIZE!!!
This form may be dropped off at the Arkansas Telephone Co. or Sew What Sewing Service
For more information, contact: Brandy Bradley @ 253-1413 or 723-4862


Contestant Name:__________________________________________________________

Address: ________________________________________________________________

________________________________________________________________________

Phone: ________________________    Age: __________    Date: ___________________

Birth Date: _____________________

Shirt Size: (please circle)        S        M        L        XL       XXL    

This event is sponsored by: Hot Country KHPQ – 92.1 FM, Master’s Touch & the Van Buren County Fair Association.

This contest is open to all counties and you must be 18 years of age to participate. From all entries received, 20 contestants will be randomly selected to compete for the elite 8 positions, which will battle it out during the fair week for the Grand Prize of $500.00!

I will not hold the Fair Association and sponsors collectively or individually responsible for any accidents that may occur during this event.

Signed: _________________________________________________________________
              (Contestant)