Online Payment Contestant's Name*Please give the contestant's name for whom you're making payment. First Last Payment Options $295 • Registration Fee Other Payment AmountPlease enter your desired amount in the box above. If you have a balance or if you need to pay for an advertisement you can do that here. NotesIf you have any notes about this payment, please make them here. 3% Online Convenience Fee* Price: $0.00 Total Who is making this payment?* I am a contestant and making a payment on my behalf. I am making a payment on behalf of a contestant. All Fees Are Non-Refundable* I understand that as soon as I submit my initial payment, the Clemente Organization automatically makes the necessary plans for my participation in the pageant. Therefore, if I should drop out of the pageant, there will be no refund of the initial payment, nor for any fees paid subsequent to the initial payment. All fees paid are not transferable. All Fees Are Non-Refundable* I understand that as soon as I submit this payment on behalf of the contestant listed above, my payment is non-refundable. Therefore, if the contestant drops out of the pageant, there will be no refund of this payment. All fees paid are not transferable. Cardholder'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* Enter Email Confirm Email Credit Card* Cardholder Name Card Details Cardholder's Signature* Δ