Entry Form - World Powerlifting Congress

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Entry Form - World Powerlifting Congress Powered By Docstoc
					                 SOUTH CAROLINA CHAMPIONSHIP
            POWERLIFTING, BENCH,PUSH/PULL MEET
 Saturday Dec. 3, 2011

 Location:     American Muscle-Fitness and Strength Gym
               8005 Edmund Hwy.
               Pelion, South Carolina 29123

 Directors:   Will Millman: APF South Carolina State Chairman
               Don Sangster: don@americanmusclesc.com
 Sanctioned by American Powerlifting Federation
 Meet Hotel: Days Inn 803-796-0044
 Eligibility: Open to APF or AAPF registered athletes. Valid card required. Lifters may register Friday July 2
              2011 for $30 (18 & under $15) Dual card $40

 Weight        Men: 114, 123, 132, 148, 165, 181, 198, 220, 242, 275, 308, SHW
 Classes:      Women: 97, 105, 114, 123, 132, 148, 165, 181, 198, SHW

 Age
 Categories:   Men’s Open: 20 & Over     Women’s Open: 20 & Over
               Teen/Junior: 13-19 Police/Fire Masters: 40 & Over

 Weigh-ins:    All weigh-ins at American Muscle-Fitness and Strength Gym
               Fri. Dec. 2, 2011 10:00am – 6:00pm
               Sat. Dec .3, 2011 8:00am – 9:00am
 Rules
 Meeting:      Saturday Dec. 3, 2011, 9:30am
               WPC Rules apply www.worldpowerliftingcongress.com
               Lifters must wear lifting suits
 Lifting
 Time:         Saturday Dec. 3, 2011 10:00am

 Awards:       Awards will be given to the top 3 places in each weight class/age category
               Raw or Equipped Plus “Best Lifter” by Glossbrenner formula

 Entry Fee:    $65 per event plus $25 for cross over, must accompany entry form
               .

Will & Marge Millman         408 Ocean Blvd. Isle of Palms, SC 29451
Phone: 843-886-5366          Fax: 843-886-3509           E-mail: Shelter804@gmail.com
                                       ENTRY FORM
            SOUTH CAROLINA CHAMPIONSHIP
                       POWERLIFTING,BENCH,PUSH/PULL
                    APF/AAPF SANCTIONED MEET
      Dec. 3 2011 @American Muscle Fitness & Strength Pelion, SC
Name:______________________________________________________________________
            Last name          First name           “Nick name”

Address:____________________________________________________________________
              Street                 City              State      Zip

Telephone#___________________________E-mail___________________________

                                                                      APF #___________
Date of Birth___________________________ Age_________            APF/AAPF #___________


First contest yes no    Number of years lifting_____ Workout gym___________________

Occupation___________________________________Personal record Squat_____________

Trophies or awards won________________________                        Bench press_________

                                                                       Deadlift______________
Records held in any sport________________________________

RAW___ EQUIPPED____            AGE ____WEIGHT CLASS _______              PL____ Bench ____ Push/Pull_____

Entry fee: $65 per event plus $25 for cross over       Total Enclosed:_____
All registered lifters will receive a “Meet T-shirt” please state size (L-XXXL)

In consideration of the acceptance of this entry thereby for myself, my heirs, executors, and administrators waive and
release any and all rights and claims for damages I may have against the APF/AAPF,Captain Will, LLC, Will Millman
Don Sangster, American Muscle-Fitness and Strength,and all officers, employees, agents sponsors, volunteers,successors a
assigns for any and all injuries or bodily harm that I may suffer while competing in this meet.

Participants signature______________________________________Date__________________

18 & under must have parent/guardian signature______________________________________

ENTRIES MUST BE RECEIVED BY Nov 28 ,2011 NO ENTRIES ON MEET DAY!!!
Make check payable to: Captain Will, LLC
Entry fee must accompany this entry form Mail to:Captain Will, LLC 408 Ocean Blvd. Isle of Palms, SC 29451
        PHONE: 843-886-5366            FAX: 843-886-3509               E-MAIL: Shelter804@gmail.com

				
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