November 21, 2009 (Saturday)

Duluth(Atlanta), Georgia

Weigh-In Schedule: (At DuluthHigh School’s Gym)

All Women & Bench Only:8:00am – 9:30amLifting Starts at 10:00am

123 – 198 Classes:8:00am – 9:30amLifting Starts at 10:00am

220 – SHW Classes:11:00am – 12:00pmLifting Starts at 1:00pm

Entry Fee: Full Power:$60 (byNov. 10th). Each additional division: $25. $75 after Nov. 10th.

(High School Lifters: $45 by Deadline Nov. 10th.)

Bench only: $50 (Deadline Nov. 10th).

Awards:Open**: 1st through 3rd for all weight classes;

**Best lifters (One in each group: light, middle and heavyweight) will receive a trophy and a gift certificate from Quest Nutrition & Athletics.

Women: 1st through 3rd by formula.

Teen:1st through 3rd (by formula) for light, middle and heavyweight groups.

Masters:1st through 3rd (by formula) for light (123-198) and heavyweight (220-SHW) groups. Special Olympics: 1st through 3rd (by formula) for light, middle and heavyweight groups.

Raw (Full Power): 1st through 3rd (by formula) for light, middle and heavyweight groups.

RULES: This is a USAPL sanctioned meet. All USAPL(IPF) rules apply. Only single ply polyester gear will be allowed and IPF approved equipments will be used. You must have a current USAPL card to lift. If you do not have one, you can purchase one at the meet. All lifters are subject to drug testing. If a lifter refuses or is not available for drug testing, the lifter will be automatically disqualified from the competition. USAPL referees will officiate.

**Entry Form**

Name: ______Date of Birth: ______Age: ____ M or F ____

Address: ______Phone: (____) ______
City/State/Zip: ______Email: ______
Send your entry form and payment by check or money order to Quest Nutrition, 3000 Mattison St., Duluth, GA30096. Tel. 770-495-0787, Fax. 770-497-1817, Email. , Web:
Divisions you wish to enter:Open ___, Masters___, Teen ___,Raw (full Power)___, Special Olympics __
Please check: Full Power _____ Bench Only ____

Weight Class ______Men’s Classes: 123,132,148,165,181,198,220,242,275, SHW

Women’s Classes: 97, 105, 114 ,123, 132, 148, 165, 198, SHW

DIRECTIONS AND WAIVER ON THE BACK!!

Quest Gym(Weigh-ins and Meet site): Quest Nutrition & Athletics

Address:3000 Mattison Street, Duluth, GA30096

Directions:Take I-85 North or South to Duluth. Get off at the Duluth Hwy (Hwy 120) exit (exit #108), and follow signs to Duluth, West.

Stay on Hwy 120 until you cross over Buford Hwy (U.S. 23), and cross over railroad tracks. Keep on Hwy 120 West through a small detour here (turn right and then left) and go for about 0.7 mile, take a right on Mattison Street. You will dead end onto Quest’s parking lot.

RELEASE FROM LIABILITY

IMPORTANT: READ THIS RELEASE CAREFULLY. WHEN YOU SIGN IT YOU WILL BE GIVNG 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 result 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 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 the drug testing. Should I fail to pass the drug tests I agree to forfeit any trophy or award which I might 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 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 the applicant is under 21 years old.

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 powerlifter: ______Date: ______