Rhino Powerlifting Club Western Province Open National Qualifier
Full Powerlifting and Push Pull Competition
Date: 21 April 2018
Venue: Perfect Health, Du Toit Street, Van Der Stel Sports Complex, Stellenbosh
Lifting starts at 09:00
Weigh-in: 20 April, 09:00-10:00 / 17:00-18:00, Perfect Health
Cost: R300 per lifter
Close of Entries: 13 April 2018
Host email: rpcwesternprovince@gmail.com
Host Contact: Andre 076 633 3658
Name: *
Email: *
I want to be added to the RPC WP Whatsapp Group *
Cell: *
Age: *
Date Of Birth: *
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Current Body Weight: *
Weight Division Entered: *
Gender *
Category: *
Class: *
Release Of Liability
In consideration of the acceptance of my entry form in this Powerlifting competition, I intend to be legally bound for not only myself, but also my heirs executors and administrators. By accepting this release from liability, I waiver and release all my rights or claims for damages I may have against the Rhino Powerlifting Club (RPC) or the sponsors/promoters of this competition.
Accept release: *
Payment:
PLEASE PAY INTO THE CORRECT ACCOUNT!
If you pay into the wrong account you will have to redo the payment into the correct account and will only be refunded your initial payment after the competition.

Of which 20% goes to RPC.
There is no affiliation required.

Type: EFT
Bank: ABSA
Branch: 632005
Account Holder: A. Engelbrecht
Account no: 407 985 1672
Reference: Athletes Name and Surname

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