(Please fill out the entire
application)
Name
____________________________________________________ Nick name
__________________________
Address
________________________________________________________ City __________________________
State________
Zip Code _____________ Sex- M __ F __ Phone Number
_________________________________
Email
address
_________________________________________________________________________________
Wt.
Class _______________ Date of birth _______________ Age on meet day __________
Are
you a 2011-12 WNPF card holder? Yes__ No__ Card # _______ or card expiration
date ____ __1__ ____
Estimated
opening attempts- SQ_______ BP ______ DL ______ PC ______ (These can be changed
at weigh-ins)
Please
check event(s) and division(s) entering below……….
Powerlifting- Youth__ Teen__ Junior__ Open__ Subs__ Masters__
Police/Fire/Military__ Novice__ Raw__ Equipped__
Ironman- Youth__ Teen__ Junior__ Open__
Subs__ Masters__ Police/Fire/Military__ Novice__ Raw__ Equipped__
Bench- Youth__ Teen__ Junior__ Open__
Subs__ Masters__ Police/Fire/Military__ Novice__ Raw__ Equipped__
Deadlift- Youth__ Teen__ Junior__ Open__ Subs__ Masters__
Police/Fire/Military__ Novice__ Raw__ Equipped__
Powercurl- Youth__ Teen__ Open__ Masters__
Reps- Teen__ Junior__ Open__ Subs__
Masters__ Police/Fire/Military__
Mail Entry
form and make payment to: Brad Spingarn OR Romeo Tendencia Send to: Powerhouse
Gym c/o Romeo Tendencia 65 Route 34 Morganville, N.J.
07751
Bank check
cash and money orders only. No personal checks accepted
If you want
confirmation of your entry received please email us.
Entry deadline
is April 28, 2012 Postmark, $30 late fee if sent in after this date, $40 late
fee if you are a walk-in lifter. Fees must and will be applied in advance or at
weigh-ins, no exceptions. Cash only at weigh-ins
In consideration of your accepting
this entry, I hereby for myself and my heirs, release any & all
rights/claims for damages for injuries I may have against the contest facility
in use, World Natural Powerlifting Federation, Troy
Ford, Ron Deamcis, all other meet directors &
staff, and any & all other participating sponsors, supporters, referees,
and spotter/loaders as a result of my traveling to, and/or from and/or
participating in, the above listed competition. I make this release and waiver
of claim with full knowledge of the hazards and inherent rights associated with
the above listed competition. I hereby assume the risk of injury and property
damage/loss. Also, in consideration of your accepting this entry I hereby sign
over my rights to be videotaped and/or photographed to the meet directors and/or
his designee. I am fully aware that I will receive no royalties and/or
compensation for resale/use of the videotapes and/or photographs. I also
realize that if I do not attend this event for any reason I will forfeit all
fees and cannot transfer them to another event. In consideration of the
acceptance of my entry in this Powerlifting
competition I intend to be legally bound, for not only myself but also for my
heirs, my executors, and my administrators. In signing this release from
liability I waive and release everyone connected with the competition from any
and all liability, including any results of negligence which may arise from
this competition. Moreover I agree that any testing method which the meet
director and the sponsors of this meet use to detect the presence of
strength-inducing drugs SHALL BE CONCLUSIVE. That is, whether I think results
of the tests are right or wrong I agree that I have no right to challenge the
results of the drug tests. I further agree to submit to any physical tests which
may be necessary to complete drug testing. Should I fail to pass drug tests, I
agree to forfeit any trophy or award which I otherwise have won. I understand
and agree that if I fail to pass the drug tests, my name will appear on a
published list of suspended members. If it is determined that I have failed the
drug test, I agree to waive any claim for which legal relief is available. I
agree to pay any attorney fee and litigation expenses incurred by any person,
real or corporate, whom I may sue in an effort to challenge this Release from
Liability form. I understand that my agreement to pay attorney fees and
litigation expenses is the Sine Qua
Non for the acceptance of my entry in this contest. If any provision of
this release form liability shall be deemed by a court of competent
jurisdiction to be invalid, the remainder of this Release of Liability shall
remain in full force and effect. I also certify with my signature that this
release/agreement cannot be modified orally. Certification: I hereby give my word of honor as an athlete
that I have not used any strength inducing drugs (i.e. any anabolic steroid,
natural hormone or synthetic growth hormone) as part of my training during the
past thirty six months, nor have I used prescription diuretics or psychomotor
stimulants during the seven days prior to this meet.
__________________________Signature in full of applicant or Signature in
full of parent or guardian if lifter is under 18 Absolutely no credit,
refunds, exchanges or transfers on any and all fees!!!!!!!!!!
JUST ADDED- STRONGEST MAN IN
THE WNPF N.J. STRONGMAN CHAMPIONSHIPS (WNPF STRONGMAN EVENTS ARE BACK)- Contact the meet directors or more information about this
event.
Meet
Location: Powerhouse
Gym 65 route 34 Morganville, N.J. 07751 (This will be an outdoor event and tents will be set up) Please use www.mapquest.com for directions or call the
gym at 732
526-7777.
Date: May 19, 2012 Times: Weigh-ins 6-7 pm on Friday and/or 8-9
am on Saturday, MANDATORY
Rules briefing 9 am, Start time 9:45-10 am
Entry fee: $80
for one division and $60 for any additional division or event. Deadline is April 28, 2012 postmark.
A late charge will and must be applied if your app is not postmarked by the due
date. If you are going to be a walk-in you must call and have your name placed
on the roster otherwise you will not be able to lift. Check out the entry form
(page 2) for late fee amounts. Absolutely
no credit, refunds, exchanges or transfers on any and all fees!!!!!!!!!!
Team fee: $80.00 per team in
advance with a team roster. (Each lifter is required to pay the regular entry fee, this fee is to add your team into the Team competition.
The best teams in 2012 by point system will
receive Championship t-shirts and a LARGE championship trophy for the 2012
season.
Membership fee: $20
high school & special Olympics, $30 college students 19-23 yrs and seniors
over 65, all others $40. Memberships expire on the 1st day of the
month purchased in the following year. This member fee can be paid in advance
or at weigh-ins. Cash only at weigh-ins.
Equipment & Rules: Please
go to www.wnpf.net/rules.htm
for all equipment specifications and rules/regulations.
Awards: 1st
thru 5th place in each division and weight class. Best lifter awards
and team awards will be awarded.
Weight classes: Youth
girls (60, 80) Women (97, 105, 114, 123, 132, 148, 165, 181, SHW)- Youth boys (60, 80, 100) Men (114, 123, 132, 148, 165,
181, 198, 220, 242, 275, SHW)
Divsions: Youth 9-10, 11-12,
Teens 13-16, 17-19, Junior 20-23, Open, Subs 35-39, Masters in 10 year increments
and Novice. RAW-
Belt, Knee sleeves, Knee wraps, wrist wraps and a singlet. Elbow sleeves are
allowed in the squat and deadlift only. Equipped- 1 or 2 ply
shirts (poly, denim or open back) and up to a maximum of 2 plies (combo squat
suit and briefs), Wraps and a belt.
Records: State
records can be set at this event. Check out the records at www.wnpf.net/records/htm No 4th attempts in this
championship.
Events: Full
Power, Bench only, Deadlift only, Squat only, Powercurl, Reps & Ironman (Bench/Deadlift
for a total)
Admission: FREE,
This is an outdoor event……..
Attire sold: Meet
shirts and more will be for sale at the meet.
Meet Directors: Brad
Spingarn the best way to reach me is by email at biff92m@optonline.net or Phone # 732
759-1925 or Romeo Tendencia at Powerhouse Gym 732
526-7777 or romeo.powerhousegym@gmail.com
Website: www.wnpf.net
for all information on the WNPF