APA Florida State Championships
October 26, 2013
First 30 Entries will get awards!!!
Meet Directors: Brian Highnote (727)482-6823
Date: Saturday, October 26, 2013 starting at 9:30 AM
Meet Location: Blessed Iron Barbell
4641 62nd Avenue North
Pinellas Park, Florida
Early Weigh in Location: Blessed Iron Barbell
4641 62nd Avenue North
Pinellas Park, Florida
Sanctioned By: American Powerlifting Association
Eligibility: Open to APA registered athletes. All athletes are required to have a valid APA membership card and must show it at weigh-in. If you fail to bring it, you will be required to purchase one onsite for $30 adults & $15 High School.
Contests: Raw Powerlifting, Raw Bench & Raw Deadlift;
Geared Bench Ony & Geared Deadlift Only
Divisions: Teen (13-19), Junior (20-23), Open, Submasters (33- 39), Master (40-49, 50-59, 60-69, 70+)
Weight Classes: Men: 114, 123, 132, 148, 165, 181, 198, 220, 242, 275, 308, SHW
Women: 97, 105, 114, 123, 132, 148, 165, 181, 198, SHW
Entry Fee: $70 per division/contest
$30 for each additional division/contest
Make checks payable to: Brian Highnote
Entry DEADLINE: October 5, 2013 (post marked)
Walk ins day of meet are not guaranteed an award!!!!
Weigh In: Friday, October 25 6:30 PM – 8:00 PM at Blessed Iron Barbell
Saturday, October 26 8:00 AM – 9:00 PM at Blessed Iron Barbell
Rules: American Powerlifting Association rules apply.
One piece lifting suits (singlets) must be worn.
Rules meeting will be at 9:30 AM.
APA Florida State Championships
ENTRY FORM
Name:
Address:
City: State: Zip:
Phone Number: Age: Email:
Expected Weight Class: Sex:
Division (circle): Teen (13-19), Junior (20-23), Open, Submasters (33-39)
Masters- 40-49, 50-59, 60-69, 70+
Contest (s), (please circle):
Raw Full Power Raw Bench Raw Deadlift Geared Bench Geared Deadlift
APA Fee $30 $
APA High School Card $15 $______
Single Contest Entry Fee $70 $
Additional Contest Entry Fee $30 $______
TOTAL DUE: $
Make checks payable to: Brian Highnote
2436 36th Ave North
Saint Petersburg, Florida 33713
MUST BE RECEIVED BY October 5, 2013
First 30 ENTRIES WILL RECEIVE TROPHY
WE WILL NOT ISSUE ANY REFUNDS FOR ANY REASON
THERE WILL BE NO GUARANTEED AWARDS FOR WALK INS OR LATE ENTRIES!
Please do not send entry in any form that will require a signature.
PLEASE DO NOT EMAIL THE ENTRIES, PAYMENT MUST ACCOMPANY ENTRY
FORM. MAKE CHECKS PAYABLE TO BRIAN HIGHNOTE.
RELEASE FROM LIABILITY:
On behalf of myself, my heirs, executors, administrators and assigns, I hereby irrevocably waive, release and fully discharge the APA, Blessed Iron Barbell, Brian Highnote, their respective officers, directors, employees, agents and shareholders, of and from any and all rights, claims, demands, lawsuits, and causes of action due to or arising from any accident, injury, damage or loss directly, indirectly, or in any way associated with my participation in the powerlifting competition sanctioned by the APA.
.
I represent that I know of no medical reason or condition that would impair my ability to participate in this event, and I hereby assume any and all risk of accidental, medical injury or consequential damages resulting from my participation. I acknowledge, understand and accept the inherent risks of powerlifting. I have read the above release, understand its meaning and consequences, and agree to be legally bound by its terms. I have signed this release freely and voluntarily:
______
Signature (in full) of applicant /Date Signature in full of parent or guardian (if applicant is under the age of 18).