Application - PurePowerlifting.com

The USAPL Gym and TLS Raw Challenge
Sanction # PA-2015-06
An Official Qualifier for 2015 USAPL Raw and Bench Press Nationals
Saturday, July 18, 2015
Trooper, PA
Entry Deadline: July 10, 2015
This is a 3-lift and single lift competition being held in Trooper, Pennsylvania. We will be
limiting the competition to the first 60 lifters registered. Get your entry in as soon as possible
to reserve your spot in the meet.
Attention: We will be using the new IPF/USAPL weight categories along with IPF Masters age
groups. This will be an equipped and unequipped (raw) event. You can enter only equipped or
unequipped (raw) – not both.
Out-of-State Lifters are welcomed to compete in the Out-of-State Division
Event Location: Gym & Tan Line Studio,
Park Ridge Shopping Center
2725 West Main Street
Trooper, PA 19403
Schedule: Saturday, July 18, 2015
Session 1:
7:00 am to 8:30 am: Weigh-in – All Women and Men 53 kgs to 83 kgs weight classes
9:00 am:
Session 1 starts
Awards to be presented at the end of each session
Session 2:
12:00 pm to 1:30 pm: Weigh-in – Men 93 kgs to 120 kgs weight classes
2:00 pm:
Session 2 starts
Awards to be presented at the end of each session
Eligibility: No qualifying totals. Lifters must be registered with the USAPL and must be drug
free by the definition of the USAPL. At least 10% of the lifters will be drug tested. USAPL
cards will be available at the meet. Non-Pennsylvania residents may compete in the Out-of-State
Divisions.
The USAPL Gym and TLS Raw Challenge
Sanction # PA-2015-06
An Official Qualifier for 2015 USAPL Raw and Bench Press Nationals
Saturday, July 18, 2015
Trooper, PA
Entry Deadline: July 10, 2015
Fees: Powerlifting (3-lifts):
$70 for the first division; $35 for each additional division
Bench Press (single lift): $50 for the first division; $35 for each additional division
Spectators (Day of Event):
$5.00 per person (payable at the door)
Weight Classes:
Women: 94.75 lbs/43 kgs (Teen and Junior Only)
103.50 lbs /47 kgs
114.5 lbs/52 kgs
125.50 lbs/57 kgs
138.75 lbs/63 kgs
158.50 lbs/72 kgs
185.00 lbs/84 kgs
185.00 lbs/84+ kgs
Men:
116.75 lbs/ 53 kgs (Teen and Junior Only)
130.00 lbs/59 kgs
145.50 lbs/66 kgs
163.00 lbs/74 kgs
182.75 lbs/83 kgs
205.00 lbs/93 kgs
231.25 lbs/105 kgs
264.50 lbs/120 kgs
264.5+ lbs/120+ kgs
Requirements/Eligibility Requirements: No qualifying totals. Must be a registered USAPL
Member (Memberships will be sold at weigh-ins. Out-of-State lifters are welcomed).
Awards: All divisions will receive awards for the top three (3) lifters, by weight class.
Raw Definition: Singlet, belt, commercial knee sleeves (example: rehbands) and wrist wraps.
Recommended hotels:
Homewood Suites by Hilton Philadelphia – Valley Forge
681 Shannondell Boulevard
Audubon, PA 19403
610-539-7300
Hampton Inn & Suites Valley Forge/Oaks
100 Cresson Boulevard
Phoenixville, PA 19460
610-676-0900
The USAPL Gym and TLS Raw Challenge
Sanction # PA-2015-06
An Official Qualifier for 2015 USAPL Raw and Bench Press Nationals
Saturday, July 18, 2015
Trooper, PA
Entry Deadline: July 10, 2015
Registration Form
Name:
Age:
Date of Birth:
Address:
Address:
City:
State:
Zip:
Phone:
Email:
Male:
Female:
Raw:
Equipped:
Pennsylvania Resident:
Powerlifting:
Yes
No
(Circle one)
Bench Press:
Division:
Open
Youth 10-13
Sub-Jr. 14-15
Sub-Jr. 16-17
Sub-Jr. 18-19
Junior 20-23
Masters 40-49
Masters 50-59
Masters 60-69
Masters 70-79
Masters 80-89
Special Olympian
Police/Fire/Military
The USAPL Gym and TLS Raw Challenge
Sanction # PA-2015-06
An Official Qualifier for 2015 USAPL Raw and Bench Press Nationals
Saturday, July 18, 2015
Trooper, PA
Entry Deadline: July 10, 2015
Fees: Powerlifting (3-lifts):
$70 for the first division; $35 for each additional division
Bench Press (single lift): $50 for the first division; $35 for each additional division
Total due:
Make checks payable to: Joe Braca
Mailing address:
629 Argyle Avenue, Ambler, Pa. 19002
Contact:
joe.braca@yahoo.com
All entries must be postmarked by July 10, 2015.
Release from Liability
Please read this carefully before signing. You will be giving up important legal rights.
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 for my heirs, my executors and my administrators.
In signing this release from liability, I waive and release everyone connected with, including but
not exclusively limited to Don Wilson, Joe Braca, The Underground Gym, Gym & Tan Line
Studio of Trooper, the spotters, the loaders, the facility owners, the referees and equipment
manufacturers associated with this competition from any and all liability, including any result of
negligence, which may arise from this competition. Moreover, I agree that any testing method
which the meet director and the sponsors of this meet use to detect the presence of strength
inducing drugs SHALL BE CONCLUSIVE. This is whether I think the results of the test are
right or wrong, I agree that I have no right to challenge the results of the drug tests. I further
agree to submit to any physical test which may be necessary to complete the drug testing.
Should I fail to pass the drug tests, I agree to forfeit any trophy or award which I may have won.
I understand and agree that if I fail to pass the drug tests, my name will appear on a published list
of suspended members. If it is determined that I have failed the drug test, I agree to waive any
claim for which legal relieve is available. I agree to pay any attorney fee and litigation expenses
by any person, real or corporate, whom I may sue in an effort to challenge this release form
liability form. I understand that my agreement to pay attorney fees and litigation expenses is the
SINE QUA NON for acceptance of my entry into this contest. If any provision of this Release
from Liability shall be deemed by a court of competent jurisdiction to be invalid, the remainder
of this Release from Liability shall remain in force and effect. I also certify with my signature
that this release/agreement cannot be modified orally.
Signature of competitor
Signature of parent or legal guardian,
if the competitor is under 18 years of age