Bench Press Competition reg flyer October 2016

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Bench Press Competition reg flyer October 2016
DOW BAY AREA FAMILY YMCA
225 Washington Ave.
Bay City, MI 48706
989.895.8596
www.ymcabaycity.org
SEMI ANNUAL
BENCH PRESS
COMPETITION
SUNDAY, OCTOBER 16 | 12:30PM
Divisions
Mens & Womens Open | Masters | Teen
Weight Classes
Mens: 52.5, 60, 67.5, 75, 82.5, 90, 100,
110, 125, 140, Super Heavy Weight
Womens: Light Weight 44-67.5, Heavy Weight 75
Weigh In
Saturday, October 15 | 11:30 - 12:30pm or
Sunday, October 16 | 10:30-11:30am
Awards will be given to the first 3 in each open weight class.
The first 3 masters and teens will be on formula.
Y-Members: $35
Program Participants: $45
Late Entry After April 1: $60
Terence Dangerfield, Competition Director 989.891.1365
*Athletes are permitted to wear spandex, lifting suit, or wrestling singlet.
No baggy pants or shorts.
REGISTRATION FORM
Contact Information
Name:__________________________________________________________________________________________________Age:_________________________
Gender (Circle One): Male Female
Address:_____________________________________________________________________________________________________________________________
City:___________________________________________ State:_______________________________________________Zip:___________________________
Phone:__________________________________Email:_____________________________________________________________________________________
Division
Mens Open
Womens Open
Masters
Teens
Weight Class (In Kilos)
Men: 52.5 56
Women:
60
44-67.5
67.5 75
82.5 90
100
110
125
140
Super Heavy Weight
Heavy Weight 75
1 Kilo = 2.2046 Pounds
Liability
By signing this, you will be giving up important rights. In consideration of the acceptance of my entry form
in this aforementioned power lifting competition, i understand that i will be legally bound for myself, my
heir, my executors, and my administrators. In signing this release from liability, I waive and release
everyone connected with this competition from any and all liability which may arise from this competition. I
understand that my agreement to pay attorney and litigation expenses is the sine qua non for the
acceptance of my entry to the contest.
________________________________________________________________
Signature of Applicant
_______________________________________________________________
Signature of Parent/Guardian If Under 18
Payment: (Must Be Paid Upon Registration)
____Cash
____Check (Payable To The Dow Bay Area Family YMCA)
___Debit/Credit Card
Name On Card: ______________________________________________________________________________________________________________________
Card Number: ____________________________________________________Expiration Date_______________________________________________

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