please complete the Online entry form below

Name *
Name
Address *
Address
Phone *
Phone
Date of Birth *
Date of Birth
Gender *
Style of Lifting *
Contest Entering *
Check All that Apply - Multiple Entries will be Discounted
Age Division *
Please check all you will be entering
If you are entering multiple entries, please tell us which divisions or contests you will be entering.
Weight Class *
Release of Liability Statement *
Release of Liability. Read Carefully. By accepting the following terms you will be giving up important rights. In consideration of acceptance of my entry form in the powerlifting/benchpress competition, I understand that I am legally bound for not only my own actions, but also for my heirs, my executors, and my administrators. In agreeing to this release from liability, I waive and release Stephen Parkhurst, Jodi Parkhurst, WUAP-USA Inc., the WUAP International Inc., the Contest Venue Location and staff, all officials, referees, spotters/loaders, and any other person or firm taking part in the competition from any and all liability which may arise from your participation in above stated the competition. I understand all of the above statements for my acceptance of my entry in this competition. By agreeing to this statement, I affirm that all information of this form is correct. I understand I may be required to sign a release of liability form during my weigh-in session.
Entry Payment Statement *
I understand that I must submit my payment to the 2016 WUAP-USA IronFest Championships at the same time as I submit this entry form. I understand I must use the PayPal method provided. I understand I do not need a PayPal Account to use PayPal. If my payment is not received within 10 minutes after I submit my entry form, I understand my entry form will be rejected and I will not be notified of the rejection.

Be sure to submit your entry form by selecting the "submit entry form" button above before selecting the PayPal Option below. Failure to do so will clear the information from the entry form. you can return to this page anytime to complete the paypal options.

Entry payment to the GrindHouse Open