MEET DIRECTORS:Chris McGrail & Jon Cunningham
801.386.6122 (chris) or 801.389.5235 (Jon)
SANCTIONED BY:APF/WPC –
EVENT LOCATION:InfinityEventCenter
26 East 600 South, Salt Lake City, UT84111
Host Hotel:Little America Hotel (4-Diamond Rating)
500 South Main Street
Salt Lake City, UT84101
1-800-437-5288 (Mention UtahPowerlifting for a rate of $85 or $95 for a 2-bed)
ELIGIBILITY:Lifters must be an APF registered athlete by the time of the meet. You can renew or get your new membership at weigh-ins or at Memberships are $30 and $15 for high school students. Current members must present their card at weigh-ins.
WEIGH-IN:All Single Ply & Multi Ply Women, Teen, and Junior:
Friday, June 26, 2015: 9:00am – 12:00pm and 5:00pm – 7:00pm
Saturday, June 27, 2015: 7:00am – 8:00am
All Single Ply & Multi Ply Open, Submaster, and Master Men:
Saturday, June 27, 2015: 9:00am-11:00am and 5:00pm-7:00pm
Sunday, June 28, 2015: 7:00am-8:00am
EVENT:MANDATORY RULES BRIEFING: Saturday & Sunday at 8:00 a.m.
Lifting begins:
All Single Ply & Multi Ply Women, Teen and Junior divisions:9:00 a.m. Saturday
All Single Ply & Multi Ply Open, Sub-Master and Master Men: 9:00 a.m. Sunday
UNIFORM:One piece lifting suit is MANDATORY. This can be a singlet and/or combination single/multi ply lifting shirt/suit.
ENTRY FEE:Entry fee is $100 if received on or prior to the DEADLINE, May 16, 2015. If received after May 16, 2015, there’s an addition $50 late fee. Additional divisions are $65 each. Cash, certified check, or money order. Certified checks, checks, and money orders are to be made out to Utah Powerlifting LLC.
AWARDS:Custom-designed high-quality medals for top 3 places in each weight class; Best Lifter Awards
SPECTATOR FEE:$10 per day; children under the age of 13 are free.
Mail entry forms and fees to:Utah Powerlifting LLC
10244 Sacramento Way
South Jordan, UT 84095
The 2015 APF National Equipped Powerlifting National Championships
June 27-28, 2015
Please Print Legibly
Full name: ______Sex (circle one): Male Female
Age ______Date of Birth ______e-mail ______
Address ______
City______State ______Zip Code ______
Phone Number ______Alternate Phone Number ______
Current APF card (circle one): No Yes If so, card number is ______
Gym or Team name: ______
Event Entered (circle all that apply):Full MeetBench OnlyDeadlift Only
Contest (circle one):Single PlyMulti Ply
Division Entered (circle all that apply): Teen: 13-1516-1718-19
Junior:20-23
Submaster: 33-39
Open
Master:40-4445-4950-5455-5960-6465-6970-74
75-7980+
Weight Class (circle one):Women:97 105 114 123 132 148 165 181 198 198+
Men:114 123 132 148 165 181 198 220 242 275 308 308+
Fees & Payment:Entry fee $100: ______
CASH, CERTIFIED CHECKS, ORIf after May 16, 2015, add late fee $50: ______
MONEY ORDERS
(No Personal Checks, please)
No Refunds
Additional divisions $65 each: ______
Meet T-Shirt Pre-Order $20 each :______
Make checks or money orders out to: TOTAL DUE: ______
Utah Powerlifting LLC
ATHLETIC RELEASE: On behalf of myself, my heirs, executors, administrators and assigns, I hereby waive, release and fully discharge any and all officials, sponsors, participants or organizations connected to the Utah Powerlifting, APF/WPC, The 2015 APF National Equipped Powerlifting Championships, Infinity Event Center and/or any affiliates of, their respective officials, directors, employees, agents and shareholders, of and from 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 2015 APF National Equipped Powerlifting Championships,June 26th thru June 28th, 2015. I, also, 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 risk of powerlifting. I have read the above release, understand its meaning and consequence, and agree to be legally bound by its terms. I have signed this release freely and voluntarily.
______
Print Lifter’s Full NameLifter’s signature
(Parent must sign if Lifter is under 18 years of age)
Return Entry Form to:Utah Powerlifting LLC
10244 Sacramento Way
South Jordan, UT 84095