APC Iron Beast Bench Press Championships.
Octonber 23, 2010
Name___________________________________________________________
Address__________________________________________________________
City _______________________State__________Zip______________________
Phone________________________________ Birth date____________________
Email____________________________________________________________
Check all appropriate categories in each column below:
Raw___
Equiped____
|
|
___Open ___Junior 20-23 Teenage: ___Sub-master 35-39 |
Master: ____40-44 |
Weight Class: Women: __44K |
|
||||
Release From Liability. Read this carefully.
By signing this you will be giving up important rights. In consideration of my
acceptance of my entry form in this powerlifting/benchpress competition, I
understand that I am legally bound for not only myself but also for my heirs, my
executors, and my administrators. In signing this release from liability I waive
and release L B Baker, Svetlana Baker, IronDawg Power, The
American Powerlifitng Committee, The Global Powerlifting Alliance, Inc.,The Iron
Beasr Gym and staff, all Officials, Referees, Spotter/Loaders and any other
person or firm taking part in this competition from any and all liability which
may arise from this competition. I understand all of the above for my acceptance
of my entry in this competition. By signing this entry form I affirm that all
the information on this form is correct.
Signature________________________________________________________
APC Card Number_______________
Parent or guardian if under 18________________________________________
24 hour weigh-in starts Friday at 10:00AM - 12:00 and 6:00PM - 8:00PM at the Iron Beast Gym.
Contest starts at 10:00AM Saturday at the Iron Beast
Gym.
Benchpress- $50.00. $30.00 for additional divisions. Team
entry fee $50.00.
Entry deadline October 15, Late
entry $20.00