Crown Order Form Miss USA Crown Miss Teen USA Crown Crown Usage Agreement1. I am choosing to purchase an optional crown for use prior to the State Pageant. Usage of this crown for appearances or photos prior to the State Pageant requires prior approval of RPM Productions, Inc. 2. Usage of my crown will be completed at the completion of the State Pageant. 3. I understand if I use this crown for public appearances that are NOT approved, or in situations exhibiting bad taste or poor judgment (i.e. alcohol, nudity, foul language) that my participation in the State Pageant may be terminated and any fees paid will be forfeited. 4. I understand that should I purchase the optional appearance sash, I may wear the sash alone, AND I may wear the crown with the sash. With the exception of professional photos, I am NOT to wear the crown alone. It must always be worn with the sash. 5. I understand I may purchase only the crown if I plan to only wear it for professional photos and/or keep as a memento. 6. I understand that I may not wear this crown to promote any pageant system other than the Miss Universe Organization.Crown Usage Agreement* I agree to all of the terms listed above. Contestant InformationName* First Last Which Pageant Are You Competing In?*Select OneMiss Alabama USAMiss Alabama Teen USAMiss Louisiana USAMiss Louisiana Teen USAMiss North Carolina USAMiss North Carolina Teen USAMiss South Carolina USAMiss South Carolina Teen USATitle* PhoneEmail Shipping Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Crown Type* Teen | $195.00 Miss | $195.00 Shipping & Insurance 5% Online Convenience Fee* Price: $0.00 Total Non-Refundable* I understand that this crown order is non-refundable. PaymentCardholder's Name* First Last Cardholder's Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Cardholder's Phone*Cardholder's Email* Credit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20222023202420252026202720282029203020312032203320342035203620372038203920402041 Security Code Cardholder Name Cardholder's Signature* Δ