Name: Email Address: Phone: City/State of residence In which category/categories do you wish to compete? Categories are Cut & Color, Up Do, Avant-Garde Hair, Glamour Makeup, Avant-Garde Makeup. Are you currently affiliated with a salon or cosmetology school? Yes No If yes, please list: Do you agree to allow any photos or video images from this event to be used by Splash Model Management and VA Fashion Week? Yes No Do you agree to indemnify and hold harmless Ann Leister Management, LLC and all company representatives from any and all claims which may result directly or indirectly out of or in the course of the performance of any assignments secured by the agency including VA Fashion Week and the model competition? Yes No I have read the rules and regulations of this competition and agree to abide by them. Yes No
