North Island Log Lift & Deadlift Champs 2021
Sunday 14th March
Kumeu Show
Kumeu Showgrounds
Competition Information
This competiton has a 2 hour weigh in.

Events:
◾Max Log Lift
◾Max Deadlift

Men's and womens categories. 🦍🇳🇿

Medal presentation will immediately follow the competition.
Payment Instructions
Entry form + fee due before February 28th 2020. $40 includes competition t-shirt or singlet.
Payment must be made in full before your registration will be accepted. No late entries or payments will be accepted.

Account details:

NZ Strongman
02-0232-0111965-000

Use your name as reference.
First Name *
Surname *
Email *
Date of Birth *
MM
/
DD
/
YYYY
Gender *
Phone number *
Physical Address *
Emergency Contact Name + Number *
Do you have any underlying respiratory conditions? *
Do you have any medical considerations that we need to be made aware of? *
Have you been hospitalised in the last 12 months? *
Are you taking any medication? *
What is your current best log lift and deadlift? *
Competition t-shirt or singlet? *
Tshirt size? *
What gym are you representing? *
Would you like to order a second competition tshirt? (Add $20) *
Would you like to order a second competition singlet? (Add $20) *
Which Class are you entering? *
Terms and conditions
North Island Log Lift and Deadlift Champs 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 New Strongman Limited, 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 New Zealand Strongman Limited, 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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