American Powerlifting Committee National Bench Press Championships.
February 11, 2006
Warner Robbins, Georgia, USA
Name___________________________________________________________
Address__________________________________________________________
City _______________________State__________Zip______________________
Phone________________________________ Birth date____________________
Email____________________________________________________________
Check all appropriate categories in each column below:
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___Open ___Junior 20-23 Teenage: ___Sub-master 35-39 |
Master: ____40-44 |
Weight Class: Women: __44K |
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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, Nadine Baker, IronDawg Power, The American
Powerlifitng Committee, The Holiday Inn 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_______________________________________________________
Entry fee: $70.00 – Team entry - $50.00.
24 hour weigh in beginning at 10:00 Friday February 10, 2006 at the Holliday Inn in Warner Robins, Ga.
Entry Deadline February 1,
2006 No Late Entries
Send check payable to Meet Director and entry form to: Meet Director, P O Box
40, Bogart, Ga. 30622, 770-713-3080 www.irondawg.com
www.americanpowerliftngcommittee.com