Name *
Name
Address *
Address
Phone *
Phone
Date of Birth *
Date of Birth
Gender *
Championship Entering *
Please Read this carefully and mark all that apply.
Age Division *
Please Check All that will apply. You will have to lift multiple times if you choose to enter multiple divisions
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 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.
Please Read Carefully