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2014 Winter Open

  • Stoney Creek Inn 101 Mariners Way East Peoria Illinois 61611 (map)

Raw and Equipped Powerlifting and BenchPress Championships

Click above for Entry Form to Print

For online entry complete the form below

 

Please Read the following completely.

Please refer to the printable entry form for weigh-in and additional information.

Name *
Name
Address *
Address
Phone *
Phone
Gender *
Date of Birth *
Date of Birth
Style of Lifting *
Select RAW or Equipped
Contests Entered *
Select Competition or Competitions Entering
Age Division *
Select your Age Division(s)
Select your Weight Class.
Team Scramble
Will you be entering a 3 lifter Team for the Team Scramble - Only one entry for Team is required.
If you are entering a team, please provide the team name and the three lifters who will be competing below.
Release From Liability. Read this carefully. By signing this you will be giving up important rights. In consideration of acceptance of my entry form in this powerlifting/benchpress competition, I understand that I am 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 Stephen Parkhurst, Jodi Parkhurst, WUAP-USA, The Stoney Creek Inn and staff, all officials, referees, spotter/loaders, and any other person or firm taking part in this competition from any and all liability which may arise from this competition. I understand all of the above for my acceptance of my entry in this competition. By signing this entry form I affirm that all information on this form is correct. I understand I will be required to sign in person a release of liability for during my weigh-in session.
Submitting this form online still requires you to submit the Entry Fee(s) by the March 1, 2014 deadline. All entries recieved after March 1, 2014 will be charged a $20.00 late entry penalty. If you wish to pay by check or money order, please mail the payment to: Stephen Parkhurst 3057 Woodside Drive Joliet, IL 60431. You may also pay using the PayPal Link below. There is a small service fee for using PayPal. Any PayPal payments received after March 1, 2014 will require the late fee be paid at weigh-in.

BE SURE TO SUBMIT YOUR FORM BEFORE MAKING A PAYMENT. YOU CAN RETURN TO THE PAGE TO MAKE A PAYMENT ANYTIME.

Entry Fee's
Later Event: March 29
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