Provincial Record Certificate Request Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

If you are requesting more than one Record Certificate, you will need to fill out a separate request form.

Email *

What is your FULL name? *

Gender *

Male

Female

Weight Class you competed in.
*

Age Category you competed in. *

Weight Class you competed in.

Female weight classes: 43kg, 47kg, 52kg, 57kg, 63kg, 69kg, 76kg, 84kg, 84+kg

Male weight classes: 53kg, 59kg, 66kg, 74kg, 83kg, 93kg, 105kg, 120kg, 120+kg

(Note: women’s 43kg and men’s 53kg only apply to sub-junior and junior competitors)

Division *

Do you compete as a Special Olympic Athlete? *

Yes

What lift did you set your record in? *

What was the weight lifted in KILOGRAMS? *

What was the name of the competition the record was set in? *

What was the date the record was set on? *

YYYY

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Saskatchewan Powerlifting Association. Report Abuse