34th WORLD ARMWRESTLING CHAMPIONSHIP

Sào Vicente, Brazil

September 11 to September 16, 2012

NAME & ADDRESS OF PARTICIPATING FEDERATION (Please print in English)
FEDERATION NAME:
PRESIDENT`S NAME:
ADDRESS:
City /

Country

/ Zip Code
TELEPHONE: / Phone / Fax / E-Mail
OFFICIAL WITH TEAM / REFEREE`S WITH TEAM
NAME / DESIGNATION / NAME / Level

PLEASE COMPLETE PAGES 2 AND 3 BEFORE COMPLETING BOTTOM PORTION OF THIS FORM

AA
BB
CC
DD
FF
GG / (carried forward from part 7)
Total Number of Men’s Entries
Total Number of Ladies Entries
Total Number of Disabled Entries
Total Number of Youth Entries
Total Number of ENTRIES
Total Number of INDIVIDUAL COMPETITORS /
______X $40.00 U.S. only =
______X $40.00 U.S. only =
______X $20.00 U.S. only =
______X $20.00 U.S. only =
______
_______
ANNUAL COUNTRY FEDERATION FEE / $300.00 U.S.
TOTAL AMOUNT DUE
TOTAL AMOUNT COLLECTED
TOTAL BALANCE DUE
PAID BY: / Cash Other US FUNDS ONLY
REGISTRAR`S SIGNATURE: / TEAM CAPTAIN SIGNATURE:
TREASURERS SIGNATURE:

PART 2 - MEN’S RIGHT & LEFT

A / MEN`S RIGHT ARM
COMPETITORS / SCALE
Weight / KG / B / MEN`S LEFT ARM
COMPETITORS / SCALE
Weight / KG
55 / 55
55 / 55
/ 60 / / 60
/ 60 / 60
65 / 65
65 / 65
/ 70 / / 70
70 / 70
75 / 75
75 / 75
80 / / 80
80 / 80
/ 85 / / 85
85 / 85
90 / 90
90 / 90
100 / 100
100 / 100
/ 110 / / 110
110 / 110
110+ / 110+
110+ / 110+
TOTAL NUMBER OF MEN`S RIGHT (A )= / 6 / TOTAL NUMBER OF MEN`S LEFT (B )= / 2

SENIOR GRAND MASTERS RIGHT & LEFT

C / 60+ RIGHT ARM
COMPETITORS / SCALE
Weight / KG / D / 60+ LEFT ARM
COMPETITORS / SCALE
Weight / KG
/ 75 / / 75
75 / 75
/ 90 / / 90
90 / 90
90+ / / 90+
90+ / 90+
TOTAL NUMBER OF MEN`S RIGHT (C )= / TOTAL NUMBER OF MEN`S LEFT (D)=


PART 3

40+ MASTERS MEN’S RIGHT & LEFT

E / 40+ RIGHT ARM
COMPETITORS / SCALE
Weight / KG / F / 40+ LEFT ARM
COMPETITORS / SCALE
Weight / KG
70 / 70
70 / 70
80 / 80
80 / 80
90 / 90
90 / 90
100 / 100
100 / 100
100+ / 100+
100+ / 100+
TOTAL NUMBER OF MEN`S RIGHT (E)= / 2 / TOTAL NUMBER OF MEN`S LEFT (F )= / 1

50+ GRAND MASTERS RIGHT & LEFT

G / 50+ RIGHT ARM
COMPETITORS / SCALE
Weight / KG / H / 50+LEFT ARM
COMPETITORS / SCALE
Weight / KG
/ 75 / / 75
75 / 75
/ 90 / / 90
90 / 90
100 / / 100
100 / / 100
100+ / / 100+
100+ / 100+
TOTAL NUMBER OF MEN`S RIGHT (G )= / TOTAL NUMBER OF MEN`S LEFT (H )=
AA / Total Number of Men Entries - Senior, Master & Grand Master & Senior Grand Masters - A, B, C, D, E, F, G & H / 11
Total Number of Individual Men Competitors / 7

PART 4

LADIES RIGHT & LEFT

I / LADIES RIGHT ARM
COMPETITORS / SCALE
Weight / KG / J / LADIES LEFT ARM
COMPETITORS / SCALE
Weight / KG
50 / 50
50 / 50
/ 55 / / 55
55 / 55
/ 60 / / 60
60 / 60
65 / 65
65 / 65
70 / 70
70 / 70
80 / 80
80 / 80
/ 80+ / / 80+
80+ / 80+
TOTAL NUMBER OF LADIES RIGHT (I)= / TOTAL NUMBER OF LADIES LEFT (J )=

MASTER LADIES RIGHT & LEFT

K / LADIES RIGHT ARM
COMPETITORS / SCALE
Weight / KG / L / LADIES LEFT ARM
COMPETITORS / SCALE
Weight / KG
60 / 60
60 / 60
/ 70 / / 70
70 / 70
80 / 80
80 / 80
80+ / 80+
80+ / 80+
TOTAL NUMBER OF LADIES RIGHT (K )= / TOTAL NUMBER OF LADIES LEFT (L )=
BB / Total Number of Ladies Entries – Senior and Master –I,J,K & L
Total Number of Individual Competitors

PART 5

M /
BOY’S Disabled
RIGHT ARM / SCALE
Weight / KG / N / BOY’S Disabled
LEFT ARM / SCALE
Weight / KG
50 / 50
50 / 50
65 / 65
65 / 65
80 / 80
80 / 80
80+ / 80+
80+ / 80+
TOTAL NUMBER OF MEN`S RIGHT (M)= / TOTAL NUMBER OF MEN`S LEFT (N )=

DISABLED

M / MEN’S Disabled
RIGHT ARM / SCALE
Weight / KG / N / MEN’S Disabled
LEFT ARM / SCALE
Weight / KG
60 / 60
60 / 60
75 / 75
75 / 75
90 / 90
90 / 90
90+ / 90+
90+ / 90+
TOTAL NUMBER OF MEN`S RIGHT (M)= / TOTAL NUMBER OF MEN`S LEFT (N )=

DISABLED GIRLS& LADIES RIGHT & LEFT

O / LADIES DISABLED RIGHT / SCALE
Weight / KG / P / LADIES DISABLED LEFT / SCALE
Weight / KG
/ 60 / / 60
60 / 60
60+ / 60+
60+ / 60+
TOTAL NUMBER OF LADIES RIGHT (O )= / TOTAL NUMBER OF LADIES LEFT (P)=
O / GIRLS DISABLED RIGHT / SCALE
Weight / KG / P / GIRLS DISABLED LEFT / SCALE
Weight / KG
/ 50 / / 50
50 / 50
50+ / 50+
50+ / 50+
TOTAL NUMBER OF LADIES RIGHT (O )= / TOTAL NUMBER OF LADIES LEFT (P)=
CC / Total Number of Disabled Entries =Boy+ Men’s Right & Left –M & N
Total Number of Disabled Entries = Girl +Ladies Right & Left – O &P
Total Number of Disable Entries =B+ Mens & G+ Ladies Right & Left
Total Number of Individual Disabled Competitors

PART 6 - YOUTH BOYS RIGHT & LEFT

Q

/ YOUTH BOY’S RIGHT ARM / SCALE / KG / R / YOUTH BOY’S LEFT ARM / SCALE / KG
50 / 50
50 / 50
55 / 55
55 / 55
60 / 60
60 / 60
/ 65 / / 65
65 / 65
70 / 70
70 / 70
80 / 80
80 / 80
/ 80+ / / 80+
80+ / 80+
TOTAL NUMBER OF YOUTH BOYS RIGHT= / TOTAL NUMBER OF YOUTH BOYS LEFT (G )=

YOUTH GIRLS RIGHT & LEFT

S / YOUTH GIRLS RIGHT ARM / SCALE / KG / T / YOUTH GIRLS LEFT ARM / SCALE / KG
45 / 45
45 / 45
50 / 50
50 / 50
55 / 55
55 / 55
60 / 60
60 / 60
65 / 65
65 / 65
70 / 70
70 / 70
/ 70+ / / 70+
70+ / 70+
TOTAL NUMBER OF YOUTH GIRLS RIGHT (F )= / TOTAL NUMBER OF YOUTH GIRLS LEFT (G )=
DD / Total Number of Youth Entries – Q + R + S + T =
Total Number of Individual Youth Competitors x $20.00


PART 7

TOTAL NUMBER OF TEAM ENTRIES

AA / TOTAL NUMBER OF INDIVIDUAL SENIOR TEAM ENTRIES (includes Master & Grand) =
MEN’S (Part 2 & 3)
BB /
LADIES (Part 4)
Total Men’s and Ladies Entries = x $40.00
CC / TOTAL NUMBER OF DISABLED ENTRIES =
DISABLED (Part 5) = x $20.00
DD / TOTAL NUMBER OF YOUTH ENTRIES =
YOUTH (Part 6) = x $20.00
FF / TOTAL NUMBER OF ENTRIES = (includes Senior, Master, Grand, Youth & Disabled)
AA+ BB+ CC+DD = FF
TOTAL NUMBER OF INDIVIDUAL COMPETITORS
AA / TOTAL NUMBER OF INDIVIDUAL COMPETITORS (includes Master & Grand) =
MEN’S (Part 2 & 3)
BB /
LADIES (Part 4)
Total Men’s and Ladies COMPETITORS =
CC / TOTAL NUMBER OF DISABLED COMPETITORS =
DISABLED (Part 5) =
DD / TOTAL NUMBER OF YOUTH COMPETITORS =
YOUTH (Part 6) =
GG / TOTAL NUMBER OF INDIVIDUAL COMPETITORS
AA + BB + CC + DD =