Contact Info: Chris McGrail (Meet Director) or Jon Cunningham (APF Utah State Chairman) Email: Phone: (801) 386-6122

Utah Powerlifting info: www.utahpowerlifting.com / www.facebook.com/utahpowerlifting

Elite Performance Gym info: www.eliteperformancegym.com

Date: Saturday, February 28, 2015, beginning at 9:00 AM (Rules Briefing at 8am)

Location: Elite Performance Gym, 7932 South 1530 West, West Jordan, UT 84088

*Turn at the Sizzler and drive straight through the parking lots until you see gym on right.

Sanctioned By: American Powerlifting Federation; visit www.worldpowerliftingcongress.com for more information

Eligibility: Open to AAPF and APF members. All APF/AAPF athletes are required to have a valid AAPF and/or APF annual membership. APF/AAPF card can be purchased on site at weigh-ins. Novice contest results are not official, and a lifter can only enter the Novice division once since it’s an introductory division into the sport of powerlifting.

Contests: Bench (Multi-ply), Deadlift Only (Multi-ply), Single-ply Bench, Single-ply Deadlift, Raw Bench,

Raw Deadlift, Powerlift (3-event Multi-ply), Single-ply Powerlift (3-event), Raw Powerlift (3-event)

Divisions: Teen (13-15, 16-17, 18-19), Junior (20-23), Open, Submasters (33- 39), Master (40-44, 45-49, 50-54, 55-59, 60-64, 65+), Open Novice (no age division, not sanctioned)

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 for sanctioned APF/AAPF competition; $35 for unsanctioned Novice

$35 for each additional division/contest

Make contest checks payable to: Utah Powerlifting LLC; Membership checks are made out to A.P.F.

Entry must be received by December 1, 2014.

Late entries will incur a $20 late fee

Awards: Medals for top 3 per weight class in each division, plus Best Lifter for men/women in

categories with three or more competitors. Novice awards are much smaller.

Weigh In: Friday, February 27th 9:00 am – 10:30 am at Elite Performance Gym

Friday, February 27th 5:00 pm – 7:30 pm at Elite Performance Gym

Saturday, February 28th 8:00 am – 8:30 am at Elite Performance Gym

Rules: American Powerlifting Federation rules apply. More info: www.worldpowerliftingcongress.com

One piece lifting suits (i.e. singlets) must be worn by all APF/AAPF sanctioned competitors;

Rules meeting will be at 8:00am on Saturday in main seating area at Elite Gym.

Unsanctioned novice lifters can wear anything besides a bench shirt or squat/deadlift suit.

Spectator Fees: Weekend Pass (Bracelet): $5.00; children under the age of 13 get in free.

Name:

Address:

City: State: Zip:

Phone Number: Age: Email:

Expected Weight Class: Sex:

Division (circle): Teen 13-15, Teen 16-17, Teen 18-19, Junior (20-23), Open, Submasters (33-39), Masters- 40-44,

45-49, Masters 50-54, 55-59, 60-65, 65+

Category Entered (please circle): AAPF APF

APF/AAPF#: Exp. Date:

Contest (s), please circle: Multi-ply Bench Multi-ply Deadlift Single-ply Deadlift Single-ply Bench Novice 3-lift

Raw Bench Raw Deadlift 3-lift Powerlift (Multi-ply) 3-lift Single-ply Powerlift 3-lift Raw Powerlift

Planned opening attempts (you can change all the way up until 8:30am on Saturday, February 28th, 2015. This is just for purposes of planning flights prior to competition: Squat: ______kg Bench Press:______kg Deadlift:______kg

APF or AAPF Member Fee $30 $

AAPF+APF Member Fee $40 $______

(Please write a separate check to the APF for member fees)

Single Contest Entry Fee $70 $

Additional Contest Entry Fee $35 $______

Late Fee (if received after 2/14/15) $20 $______

TOTAL DUE: $

Make contest checks payable to: Utah Powerlifting LLC Make APF membership fee checks payable to: A.P.F.

Mail entries and fees to: Utah Powerlifting, 10244 Sacramento Way, South Jordan, UT 84095

MUST BE RECEIVED BY February 14th , 2015 (to avoid the late fee)

WE WILL NOT ISSUE ANY REFUNDS FOR ANY REASON

THERE WILL BE NO SAME DAY SIGN UPS ALLOWED

Please do not send entry in any form that will require a signature.

METHOD OF PAYMENT: ______PERSONAL CHECK______MONEY ORDER (or Certified Check)

*PLEASE DO NOT EMAIL THE ENTRIES; PAYMENT MUST ACCOMPANY ENTRY FORM. MAKE CHECKS PAYABLE TO: UTAH POWERLIFTING LLC

RELEASE FROM LIABILITY

On behalf of myself, my heirs, executors, administrators and assigns, I hereby irrevocably waive, release and fully discharge the APF, Utah Powerlifting LLC, Elite Performance Gym, their respective officers, directors, employees, agents and shareholders, of and form 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 sponsored by the American Powerlifting Federation (APF).

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)