2019 NPC Southeastern USA Registration
Event Date: June 1, 2019
Event Address: Jefferson High School: 4401 W. Cypress St., Tampa, FL 33607
Contact us at (407) 474-8502 or chris.eaddy@gmail.com
Email address *
PAYMENT
Payment is due at the time of registration or the registration will be cancelled. Please use the PayPal button on the previous website to process payment after completing this form.
COMPETITOR NAME
First *
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Last *
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COMPETITOR ADDRESS
Address Line 1 *
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Address Line 2
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City *
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State *
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Zip Code *
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Phone *
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COMPETITOR INFORMATION
Age *
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Height *
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Weight *
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OPEN MEN'S BODYBUILDING *
Required
MASTERS MEN'S BODYBUILDING *
Required
MEN'S CLASSIC PHYSIQUE *
Required
MEN'S PHYSIQUE *
Required
WOMEN'S FIGURE *
Required
WOMEN'S PHYSIQUE *
Required
BIKINI *
Required
RELEASE
In consideration of being allowed to participate in any way in the NPC Southeastern USA (“Event”) promoted by Chris Eaddy (Promoter”) and sanctioned by the National Physique Committee of the USA, Inc. (“NPC”), its related events and activities, the undersigned, acknowledges, appreciates and agrees that:

1. The risk of injury from the activities involved in this Event is significant, including the potential for permanent paralysis and death, and while particular skills, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist;

2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE PROMOTER AND/OR THE NPC or others, and assume full responsibility for my participation;

3. I willingly agree to comply with the stated and customary terms and conditions for participation; if, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the Promoter immediately;

4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS the Promoter and the NPC and each of their officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used for the activity (“Releasees”), WITH RESPECT TO ANY AND ALL INJURY DISABILITY, DEATH, or loss or damage to person or property associated with my presence at or participation in or in traveling to and from the Event, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

5. The undersigned further consents and agrees that the undersigned will comply with all rules and regulations of the Four Points by Sheraton, 4400 W. Cypress St., Tampa, FL 33607 (“Hotel”) including any rules or regulations prohibiting cooking or food preparation in the hotel rooms. The undersigned further agrees that the undersigned will indemnify and hold harmless the NPC and the Promoter from and against any damages caused by the undersigned to the Hotel or damages to a guest room or rooms occupied or registered to the undersigned. Finally, the undersigned acknowledges that the undersigned’s failure to comply with any rule or regulation of the Hotel or damage to any guest room occupied by or registered to the undersigned may result in disciplinary action against the undersigned including, but not limited to, suspension as a member of the NPC and/or competing in contests sanctioned by the NPC. And in further consideration of permission being granted to me to participate in the Event and its related events. I hereby grant the NPC, Promoter and/or any other NPC-approved video or entertainment organization and all of their agents, successors, licensees and assigns, the right to photograph or otherwise reproduce (whether by film, tape, still photography or otherwise) my voice, appearance and name, and to exhibit, distribute, transmit, and/or otherwise exploit any and all media, including without limitation, by means of still photography, motion pictures, radio, television, television motion pictures, video, printing on digital or any other medium now known or hereafter devised, including with respect also to any merchandising, advertising and/or publicity, and the right to use my name and information about me in any connection with any of the foregoing. The rights granted by me hereunder are granted for the entire universe and shall endure in perpetuity and no further compensation shall be payable to me at any time in connection therewith. Nothing contained herein shall be deemed to obligate the NPC, Promoter, and/or any other NPC-approved video or entertainment organization, to photograph or otherwise reproduce my voice, appearance or name, or to make use of any rights granted herein. I also understand that the aforementioned rights may be reassigned at any time without further consent. I understand that the NPC, the Promoter and/or any NPC-approved video or entertainment organization, are videotaping and photographing the Event in express reliance upon the foregoing, and I represent and agree that I am free to grant the rights granted to the NPC, Promoter and/or any other NPC-approved video or entertainment organization hereunder.
If you are a competitor who has special needs of any kind, it is imperative that you make the Event Promoter aware of your need prior to the event so that they can adequately prepare for you competing at the event.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVE UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
Electronic Signature *
Required
Athlete First and Last Name *
Your answer
Date *
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Age *
Your answer
Electronic Signature of Participant Requesting Accommodations
Please Indicate If You Require a Service Animal
Your answer
MINOR RELEASE
FOR PARENTS/GUARDIANS OF PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT THE TIME OF REGISTRATION)

This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releasees, and, for myself, my child and our heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child’s involvement or participation in these programs as provided above, EVEN IF ARISING FORM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law.
Parent/Legal Guardian Signature
Parent First and Last Name
Your answer
Date of Parent Signature
MM
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DD
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YYYY
INFORMATION
Eligibility: This event is open to any competitor in the United States and is a national qualifier.

Entry Fee: Entry fee is $100.00 per class. Crossovers are unlimited in all categories and divisions. Each crossover is an additional $100.00. THERE WILL BE A LATE FEE OF $50.00 FOR ENTRIES AFTER May 24, 2019. NO REFUNDS.

Mandatory Check In: All athletes must weigh-in and register from 6:00 pm to 8:00 pm at the Venue (Jefferson High School) on Friday, May 31, 2019. Bodybuilders and Classic Men’s Physique will need to wear posing suits at weigh in. Bikini competitors must wear their suit at check in. No entries or weigh-ins will be allowed on the day of the show - - No Exceptions!!

Music: A quality CD must be provided and cued to 60 seconds for men's bodybuilding, men's classic physique, and women's physique competitors only.. If your CD is not working we will use house music for posing.

Alcoholic Beverages: In accordance with Florida law, NO alcoholic beverages are permitted on school property, whether open or sealed. Any violation thereof will result in automatic disqualification and possible arrest.
A copy of your responses will be emailed to the address you provided.
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