Powerlifting Entry Form
Please fill out to the best of your ability.
We can make the changes on the day of weigh-ins.
Email *
First and Last Name *
Street Address *
City *
State *
Zip *
Weight Class *
Division *
Required
Group *
Required
Class *
Squat Opener LBS *
Bench Opener LBS *
Dead Lift Opener LBS *
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.
A copy of your responses will be emailed to the address you provided.
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