2016 Great Plains Olympus-Contestant Registration
1. Complete the Contestant Registration in its entirety online.
2. Attach an electronic copy of the front of your driver's license with the numbers blacked out, clearly showing proof of your age.
3. Your bio should be input on this form. (max. 750 words) - After 750 words, your bio will be cut off.
4. Attach an electronic copy of your headshot photo (max. 3" x 3", 300dpi, 800 x 600 pixels or greater- JPG or PNG).
5. Contestant registration fee ($25) is due at the time of submitting this form and is non-refundable. Please make payment to Texas Leather Productions, and mail to Texas Leather Productions, 6510 Abrams Road, Dallas, TX 75231 or drop off payment at the front desk of the Dallas Eagle in an envelope addressed to Great Plains Olympus Leather. Do not submit cash; check or money order only.
Mr. Great Plains Olympus Leather
Ms. Great Plains Olympus Leather
Address Line 2
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Bosnia and Herzegovina
British Indian Ocean Territory
Central African Republic
Democratic Republic of the Congo
Republic of the Congo
Papua New Guinea
Saint Kitts and Nevis
Saint Vincent and the Grenadines
Sao Tome and Principe
Trinidad and Tobago
United Arab Emirates
United States Minor Outlying Islands
Virgin Islands, British
Virgin Islands, U.S.
Landline Phone Number (if applicable):
Cell Phone Number
Pronoun Preference: (He, She, Sir, slave, etc.)
Specific Medical or Other Needs:
Do you have a current passport:
Family Structure (single, partnered, triad, etc.)
Must be between
Have you ever appeared in any pornographic photos, films or videos?
Have you ever been arrested, indicted or convicted of a felony? (Note: A yes response does not automatically disqualify a contestant from participating.
Do you hold any current title(s):
Do you hold any previous titles:
What clubs are you a member of? Please include how long and any positions held within the club.
Club Leader we may contact:
Club Leader Email:
Club Leader Phone Number:
Length of time in the community:
Community Reference #1 we may contact:
Community Reference #1 Email:
Community Reference #1 Phone Number:
Community Reference #2 we may contact:
Community Reference #2 Email:
Community Reference #2 Phone Number:
Hankie Colors - Flagged Right:
Hankie Colors - Flagged Left:
Must be at least
Briefly, what do you hope to accomplish during your title year:
Must be between
I, the undersigned, agree to comply with all the rules and regulations set by Great Plains Olympus Leather, my regional producer and the management of the facilities where the events are held.
I certify that all information I have provided on this form is accurate.
I certify that I am 21 years of age or older and meet all of the qualifications specified in the CONTESTANT REQUIREMENTS portions of this application and agreement. I further agree to comply with all of the requirements described within this attached application and agreement contract and with the statements of expectations and responsibilities of the winners.
I certify that I have read and fully understand the Contestant Requirements located at www.GreatPlainsOlympusLeather.com
I understand that registration is not considered final until payment is received.
DISCLAIMER AND RELEASE OF LIABILITY:
I, the undersigned, in consideration of the acceptance of my entry herewith by the owners the contest, Great Plains Olympus Leather, hereby waive, release and forever discharge its owners, producers, members, agents, operators, employees, lessors, lessees, parent companies or entities, affiliated companies or entities, representatives or subsidiaries from any and all demands, actions, causes of actions, claims of injury or damage to my person, property or reputation, costs, damages, expenses, attorney’s fees or penalties of any kind or nature, whether asserted or unasserted, known or unknown, that may arise now or in the future from any cause whatsoever in connection with my participation in and with the Great Plains Olympus Leather.
I, the undersigned, also hereby grant to Great Plains Olympus Leather and its licensees, agents, successors and assigns, the exclusive right and permission to own, print, reprint, broadcast, reproduce, and publish any and all photographs, negatives, video and audio recordings, and other electronic media and mechanical images of me, which are taken during any local, regional or international competitions, rehearsals, photographic modeling sessions, receptions or other related events. All photographs and images of me shall be the property of Great Plains Olympus Leather, who shall have the exclusive right to use the photographs and images for any purpose whatsoever in any media or context.
I agree to participate, if asked to do so, in a photographic modeling sessions arranged by the Great Plains Olympus Leather producers during the Great Plains Olympus Leather Weekend Contest at a location within the United States or Canada. I understand that the photographs may be used exclusively by Great Plains Olympus Leather in its advertisements, website and promotional activities, and for no other purpose unless I grant written permission. I understand that nudity is not required but is optional. I shall receive no compensation for modeling other than the prizes that are awarded to me, if any, as a contest winner.
I hereby release, discharge and agree to hold harmless Great Plains Olympus Leather, its producers, officers, Board of Directors, board, and agents, photographers, licensees, agents, successors and assigns, including all publishers, distributors and web masters who may publish, distribute, broadcast, or otherwise use photographs and images of me, from any liability or claim arising from the publication, distribution, broadcast, or other use of any photographs and images of me, including any distortion, blurring, alteration, optical illusion, or use in composite form, either intentionally or otherwise, that may occur or be produced in the taking, processing, or reproduction of the photographs and images of me, their publication, distribution or broadcast.
I certify that I am (21) twenty-one years of age or older, and have read these releases before signing them. I have attached a photocopy of the front page of my driver’s license (with the numbers blacked out) which shall be used for identification purposes only and shall not be published.
Signature (By typing your name below, you affirm that all information you have entered is accurate)
Head Shot: (Please note, your photo may be used on our website and other social media, as well, as provided to the judges in their judge’s book.) Photo should be at least 300 dpi.:
Please check the box below.
Do Not Fill This Out