Date: Aug. 4Th, 2012 On-Site Professional Photography!

Date: Aug. 4th, 2012 On-site Professional Photography!

Location:Midland Resort Convention Center

1500 W. Wackerly St.

Midland, MI 48642

Hotel

Accommodations: Midland Resort (989-631-4220)

Reduced Room Rates ($59.00/night (normally $89.00))

Entry Fee:$50 for open division (EVERYONE IS AUTOMATICALLY IN THE OPEN)

$30 for additional division(Masters, Teens, Jr’s)

Please make checks/money orders out to: Matt Smith

Meet Director:Matt Smith:

Entry Dead Line:July 13th, 2012 ($30 late fee applies after this date)

NO ENTRIES ACCEPTED AFTER JULY 27nd!

A minimum of 10% Drug Testing via Urinalysis

Rules & Eligibility: This meet is sanctioned by USAPL. All lifters must be registered with USA Powerlifting. Membership cards will be available at the meet (Adults $45, teens $30). All athletes will comply with USAPL rules for equipment and lifting on the platform.

Important Times: Equipment check and Weigh-In:7:00-8:00AM

Lifting begins: 9:00AM

Divisions & Awards: All entries will be in Open Divisions!

Additional entries will be for age specific categories!

If you only enter Open and you set a record in an age specific division it will still count as a state record.

Men’s: (114, 123, 132, 148, 165, 181,198, 220, 242, 275, SHW)

Raw Open: 1st - 3rd (each weight class) ages: ALL!

Equipped Open:1st - 3rd (each weight class) ages: ALL!

Women’s:(97, 105, 114, 123, 132, 148, 165, 181, 198+)

Same as above for men

Best Lifter Awards: Mens: Bench Only (raw and equipped combined)

Full Meet (raw and equipped combined)

Womens: Bench Only (raw and equipped combined)

Full Meet (raw and equipped combined)

ENTRY FORM ADDRESS:

Smitty's Iron Works

601 E. Wackerly St.

Midland, MI 48642

(989)-837-8700

Entry Form (Please Print or Type)

Name: ______Age: ______Sex: MaleFemale

Address: ______

StreetCityStateZip code

Phone: ______E-mail: ______

Weight Class: ______USAPL #: ______(memberships available at meet)

Check Division(s) Entered: Teen: 14-15( ) Teen:16-17( ) Teen:18-19( ) Junior: 20-23 ( ) Open: All Ages ( )

Masters:( )40-44( )45-49( )50-54( )55-59( )60-64 ( )65-69( )70+

Check Event(s) Entered: _____ Bench Only _____ Full Meet ______Raw ______Equipped

Release from Liability

Read this carefully. When you sign it, you will be giving up important legal rights.

In consideration of the acceptance of my entry blank 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 this 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 the results of the test are right or wrong, I agree that I have no right to challenge the results of the drug test. I further agree to submit to any physical tests, which may be necessary to complete the drug testing. Should I fail to pass the drug test, I agree to forfeit any trophy or award, which I might otherwise have won. I understand and agree that if I fail to pass a drug test, 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 cooperate, 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 into this contest. If any provision of this Release from Liability shall be deemed by a court of competent jurisdiction to be invalid, the remainder of this Release from Liability shall remain in full force and effect. I also certify with my signature that this Release/agreement cannot be modified orally.

______

Signature in full of ApplicantSignature in full of parent or guardian if applicant is under the age of 18 years

I herby 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 (36) months, nor have I used prescription diuretics or psychomotor stimulants during the seven (7) days prior to this meet.

______(Signature in full of the applicant)

ENTRY FORM ADDRESS:

Smitty's Iron Works

601 E. Wackerly St.

Midland, MI 48642

(989)-837-8700

Entry Form (Please Print or Type)

Name: ______Age: ______Sex: MaleFemale

Address: ______

StreetCityStateZip code

Phone: ______E-mail: ______

Weight Class: ______USAPL #: ______(memberships available at meet)

Check Division(s) Entered: Teen: ( ) 14-19Junior:( ) 20-23Open:( ) All Ages

Masters:( )40-44( )45-49( )50-54( )55-59( )60-64 ( )65-69( )70+

Check Event(s) Entered:_____ Bench Only_____ Full Meet ______Ironman

Release from Liability

Read this carefully. When you sign it, you will be giving up important legal rights.

In consideration of the acceptance of my entry blank 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 this 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 the results of the test are right or wrong, I agree that I have no right to challenge the results of the drug test. I further agree to submit to any physical tests, which may be necessary to complete the drug testing. Should I fail to pass the drug test, I agree to forfeit any trophy or award, which I might otherwise have won. I understand and agree that if I fail to pass a drug test, 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 cooperate, 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 into this contest. If any provision of this Release from Liability shall be deemed by a court of competent jurisdiction to be invalid, the remainder of this Release from Liability shall remain in full force and effect. I also certify with my signature that this Release/agreement cannot be modified orally.

______

Signature in full of ApplicantSignature in full of parent or guardian if applicant is under the age of 18 years

I herby 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 (36) months, nor have I used prescription diuretics or psychomotor stimulants during the seven (7) days prior to this meet.

______(Signature in full of the applicant)