NZ Log Lift & Deadlift Champs 2019
Saturday 5th October 2019
Matamata A&P Show
Station Road, Matamata
Payment Instructions
Entry form + fee due before 21st September 2019. $30 includes competition tshirt.
Payment must be made in full before your registration will be accepted.

Account details:

NZ Strongman

02-0232-0111965-000

Use your name as reference.
First Name *
Your answer
Surname *
Your answer
Email *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Gender *
Phone number
Your answer
Do you have any medical considerations that we need to be made aware of? *
Your answer
Have you been hospitalised in the last 12 months? *
Your answer
Are you taking any medication? *
Your answer
What is your current best Log Lift & Deadlift? *
Your answer
Which gym are you representing? *
Your answer
Tshirt size? *
Which Class are you entering? *
Terms and conditions
New Zealand Log Lift & Deadlift Champs 2019 Informed Consent/Release of liability

By entering this contest, I acknowledge that this is an extreme test of a person’s physical and mental limits and carries with it the potential for serious injuries and even death. In consideration of my entry; I hereby, for myself, executor and administrators, and my assignees, waive and release all rights and damages I may have against the Auckland Strongman Series, owners, directors, employees, representatives, and agents, the event holders, event sponsors, event volunteers, and all others acting or representing, in part or full, the above persons or affiliates from any and all liabilities, injuries by me in conjunction with this event and in traveling to and from the event that may result in my participation in this contest. I have carefully read this information and understand it. I therefore affix my signature below.

In consideration of my application and permitting me to participate in this event, I certify that I am physically fit, have sufficiently trained for participation in the event and have not been advised otherwise by a qualified medical person. I understand, and have been informed that there exists the possibility of adverse changes when engaging in a physical activity program. I have been informed that these changes could include abnormal blood pressure, fainting, disorders of heart rhythm, stroke, and very rare instances of heart attack or even death. I have been told that every effort will be made to minimize these occurrences by proper screening and by precautions and observations taken during the exercise session.

I understand that there is a risk of injury, heart attack, or even death as a result of my participation in this event, but knowing those risks, it is my desire to partake in the recommended activities. I release all rights to sue or take legal action against Auckland Strongman Series, owners, directors, employees, representatives, and agents, the event holders, event sponsors, and event volunteers.

I have been given an opportunity to ask questions about this event. I further understand that there are also other remote health risks. Despite the fact that a complete accounting of all these risks has not been provided to me, I still desire to proceed with this event. I acknowledge that I have read this document in its entirety or that it has been read to me if I have been unable to read same. I consent to the rendition of all services and procedures as explained herein by all program personnel.
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