2019 ENTRY FORM FOR USA Powerlifting Happy New Year Powerlifting Meet 1/26/2019 Sanctioned by USA Powerlifting: WI-2019-07
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Email address *
Name *
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Male/Female *
Birth Date: Month/Day/Year *
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RAW/EQUIPPED *
Division *
Weight Classes: WOMEN:43 kg* 47 kg, 52 kg, 57 kg, 63 kg, 72 kg, 84 kg, 84 kg+ *Teen/Junior Only MEN: 53 kg 59 kg, 66 kg, 74 kg, 83 kg, 93 kg, 105 kg, 120 kg, 120 kg+ -----Youth Girls: 30k (66lb), 35K (77lb), 40k (88lb), and then the already set weight classes. Youth Boys: 30k (66lb), 35k (77lb), 40k (88lb), 44k (97lb), 48k (105lb) and then the set classes(ALL WEIGHTS MUST BE PUT IN KILOS) *
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Contact Info: Phone Number and Email *
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USAPL Card Number and Expiration Date *Indicate "Applied For" if you have not acquired one yet. *
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Emergency Contact Number *
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