Powerlifting Entry Form
Please fill out to the best of your ability.
We can make the changes on the day of weigh-ins.
Email address *
First and Last Name *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Weight Class *
Division *
Required
Group *
Required
Class *
Squat Opener LBS *
Your answer
Bench Opener LBS *
Your answer
Dead Lift Opener LBS *
Your answer
Waiver​:
In consideration of the acceptance of this entry, I hereby for myself, my heirs, executors, and administrators waive and release any and all rights and claims for damages I may have against the UPA, Heather Gibson, Jason Gibson, Ryion Butcher, Kristin Butcher, BioFit Bootcamp, PSM Barbell, Spotter, Loaders, their representatives, successors, and assigns for any and all injuries or bodily harm that I might suffer while competing in this event.
Signature *
By typing your first and last legal name. You are agreeing to the waiver statement and submitting your entry for participation.
Your answer
A copy of your responses will be emailed to the address you provided.
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