Weightlifting

Scotland

SCOTTISH YOUTHS

WEIGHTLIFTING CHAMPIONSHIPS 2014

SATURDAY 5 APRIL 2014

Kilmarnock Weightlifting Club, Shortlees Community Center

Blacksykes Avenue Shortlees Kilmarnock.

Weigh-In 8am – 9am. Start 10am

ENTRY FORM

Organiser – Graham Haydon (grahamhaydon06 @aol.com)

Please complete this form fully and in BLOCK CAPITALS

Name
Address
Post Code:
Date of Birth / Gender
Contact Phone No. / E-mail
CLUB / WLS Membership No.
2014 Scottish Youths Weightlifting Championships
BWT Class Please circle (or shade) the correct value
PLEASE CIRCLE BELOW / PLEASE CIRCLE BELOW
Men: / 56 / 62 / 69 / 77 / 85 / 94 / 105 / 105+ / Women: / 48 / 53 / 58 / 63 / 69 / 75 / 75+
Total Achieved
Current Age / Years: Months

l You should note that the closing date for entries is the 29th March 2014

(1 week Before the Event)

l Your WLS Membership Card must be shown at the weigh-in / Photo ID must also be shown at weigh-in / Birth Certificate to be shown at the Weigh-In if you intend breaking records. No WLS Membership Card and Photo ID then you will not take part in the competition.

Photo ID can be in the form of Driving Licence, Provisional Driving Licence, Passport,

Current and Valid Student ID Card.

l Competitors will be notified of any changes to the above details, e.g. weigh in time.

l With this entry form you must enclose the following:

Entry Fees Scottish Youth Weightlifting Championships £15

Cheques made payable to: Kilmarnock Weightlifting Club All Entry’s sent to Club Secretary MR Graham Haydon 47. Muirfield Place Kilwinning KA13 6NZ

Parental Consent form (if under the age of eighteen (18)

No entries will be accepted after the deadline date of 29th March 2014.

(1 week Before the Event)

I agree to be bound by the rules and regulation of WLS and declare that I am physically fit to undertake the sport of weightlifting and have no knowledge of any medical condition which will make weightlifting contra-indicated to my well being.

Signed ______Date ______

Conditions of Entry to the Scottish Youth Weightlifting Championships 2014

1)  There are no Qualifying Totals for these Championships.

That your entry is received by 29th March 2014 with the entry fee of £15

(1 week Before the Event)

2)  That, if you are taking any medication whatsoever you have checked whether it is prohibited or not prohibited on the UK Anti Doping Organisation (UKADO) Drug Information Database Shortcut to: http://www.globaldro.com/uk-en/default.aspx. For advice, contact .

WEIGHTLIFTING SCOTLAND (WLS)

UNDER 18 PARENTAL CONSENT AGREEMENT FORM

ANTI DOPING AND DISCIPLINARY REGULATIONS

I ______(name) of ______

______(address)

Confirm that I have parental / guardian authority for

______(athlete’s name)

I confirm that:

(1)  I give permission for my son / daughter to compete in the Scottish Youth Championships on Sat 5 April 2014 and confirm that he / she is physically fit to undertake the sport of weightlifting.

(2)  I consent and agree to my son / daughter complying with anti doping testing, and being bound by all the provisions of the Anti-Doping Rules, and any determinations made in accordance with BWL/WLS Anti-Doping Rules.

I understand that a refusal to provide a consent may affect the athlete’s involvement in WLS/BWL events and activities and WLS may refuse to allow the athlete to participate in such events.

(3)  My son / daughter is taking / not taking* a prescribed medication by our doctor or pharmacist (delete where appropriate)

If your child is taking any medication then contact the immediately for advice. Medication for asthma may be prohibited by the International Olympic Committee and World Anti Doping Agency, but the BWL can help you apply for an exemption.

(4)  I consent to photographing and videoing of my child in the weightlifting competition under the stated rules of the WLS/BWL Child Protection Policy.

Signed ______

Date ______

Data Protection Act 1984: Information supplied on this form may be held on computer.