BRITISH POWERLIFTING UNION


East Midlands & South Yorkshire Qualifiers for the European Championships 2018 and British Championships 2018

31 March & 1 April 2018

Start time: 9am both days

Venue: IAG Gym, 175 Effingham St, Rotherham S65 1BL

Entries will close as soon as the places are filled

£30.00 per entry - £50 for 2 categories. Please tick

Full Power…….. Bench Only……… Deadlift Only……...

RAW……… CLASSIC RAW (with Knee Wraps)……… Multi Ply..…….Single Ply ………..

Teen………… Junior……… Open ………. Master…………

Saturday 31: All women’s classes, all men’s teens and juniors AND men’s open and masters up to and including 82.5kg

Sunday 1: all men open and masters from 90kg and upwards

All competitors please complete this section

Please note: You MUST complete all fields, otherwise the entry will not be accepted

ABPU or BPU? ………………………………………………………………….

First name: ………………………………………………………………….

Surname ………………………………………………………………….

Address ………………………………………………………………….

………………………………………………………………….

POSTCODE ………………………. PHONE NO: …………….……….

MEMBERSHIP NO: BPU……………………………ABPU...................... (please tick which you are entering and include your 2017/18 membership number – if no number yet, the date you paid. YOU MUST HAVE A CURRENT 2018 MEMBERSHIP NUMBER WHEN YOU COMPETE)

D.O.B ………………… AGE ON DATE OF COMP: ………………

Email Address …………………………………………………………………

Method of payment: Bank Transfer:…………….. Paypal:……………..Cheque……………

ALL COMPETITORS PLEASE COMPLETE

BODYWEIGHT (Please circle bodyweight class)

Men 52 56 60 67.5 75 82.5 90 100 110 125 140 140+

Women 44 48 52 56 60 67.5 75 82.5 90 90+

Payment: How to pay for your entry

First, you MUST be a member of the federation, otherwise your entry is null and void. If you have taken membership but not received your number yet, please state “applied for” – DO NOT leave it blank.

Payment for the competition is being made directly to the promoter. You can pay the following way:

Paypal: (please remember to make payment through the friends and family route, otherwise the promoter will be charged fees)

Bank Transfer:

Account Num 51285815

Sort code 40-47-72

+++Please ENSURE you put your name as a reference when making payment +++

I hereby agree to enter this competition on the following terms:

1/ In consideration of the acceptance of this entry thereby for myself, my heirs, executors, and administrators waive and release any and all claims and damages I may have against the BPU, the organisers, Venue owners, their representatives, successors, and assigns for any and all injuries or bodily harm that I may suffer while competing at the BPU & ABPU East Midlands and South Yorkshire Regional Qualifier. I attest and verify that I have full knowledge of the risks involved with my participation in this event, and that to the best of my knowledge I am physically fit and able to participate in this event.

2/ That I know of no reason why I should not take part on the grounds of ill health,

3/ I have paid my entry fee of (£30.00) (£50.00)

to paypal or bank, which I understand is non-refundable, Tick appropriate fee above.

4/ Entry form and fee to be sent by post to:

British Powerlifting Union, c/o 22 Ivy Cottages, Meadow Lane, Denton, Manchester, M34 7PZ OR

5/ Please note that entries will close as soon as all the places are filled. There are 40 places available per day.

5/ Please email all entries unless postal to

Signature : ……………………………….. Date : …………………..

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I am the Parent / Guardian of ………………named above who is under 18 years of age and I confirm acceptance of the above terms on his/her behalf

Signature : …………………… Print Name : …………………………