LilMendy
01-31-2010, 08:47 PM
Come join us for this awesome event!
May have some special guests putting up some crazy numbers!!
2010 APF NEW YORK STATE RECORD BREAKER
FULL POWER CHAMPIONSHIPS
APRIL 24TH, 2010
SPONSORED BY:
APF NY STATE CHAIRMAN SHAWNA MENDELSON & CHRIS TAYLOR
[email protected]
EVENT LOCATION: WORLD GYM
207 LITTLE EAST NECK ROAD,
WEST BABYLON NY 11704
www.worldpowerliftingcongress.com
516-993-6378
HOST HOTEL: TBD
ELIGIBILITY: Open to all APF registered athletes. 60 lifters Maximum
WEIGH-IN: WORLD GYM
24 hour weigh in rule will apply.
Friday April 23rd 11:00am - 4:00 pm
Saturday April 24th 8:00 am – 10:00am
COMPETITION: Mandatory rules briefing Saturday at 10:30 am
LIFTING SCHEDULE: Saturday April 24th Meet Starts at 11am Sharp!
UNIFORM: Mandatory - Must have one piece lifting suit or wrestling suit.
APF Rules apply.
CONTEST LIFTS: Squat - Bench Press – Deadlift and/or Bench Press Only
ENTRY FEE: A fee of $100 must accompany this entry form and be received no later than April 17th, 2010. $50.00 late fee for any entries allowed in after the deadline.
AWARDS: 1-3rd place and Best Lifter in each category based on content of entries.
2010 APF NEW YORK STATE RECORD BREAKER
FULL POWER CHAMPIONSHIPS
APRIL 24th, 2010
Entry Form
Competitor:
Last Name First Name MI
Address __________________________________________________ _______________________
City _________________________________ State ____________ Zip Code _________________
Home Phone _______________________ Work Phone ______________________ Age ________
e-mail ___________________________________________ Date of Birth _____________________
Division Entered: □Open □Junior 20-23 □Teen13-15 □16-17 □18-19 □Submaster 33-39
□Masters 40-44 □45-49 □50-54 □55-59 □60-64 □65-69 □70-74 □75-79 □80-84
□ Police/Fire/Military
Class Entered Men: 114 123 132 148 165 181 198 220 242 275 308 SHW
Class Entered Women: 97 105 114 123 132 148 165 181 198 Unl
Men □ Women□ Wt Class____________ □Powerlifting □Bench Press □Both (must lift in both)
Fees & Payment:
Late fee after 4/17/2010 $50 $___________
APF# _________ Exp. Date __________
Entry fee Powerlifting $100 $___________
Entry Fee Bench $70 $___________
TOTAL DUE $___________
Paid: □Cash □ Check
Waiver:
In consideration of the acceptance of this entry, I hereby for myself, my heirs, executors, and administrators waive and release any and all rights and claims for damages I may have against the APF, AAPF, Shawna Mendelson, WORLD GYM Inc. their representatives, successors, and assigns for any and all injuries or bodily harm that I might suffer while competing at the 2010 APF NY State Championships, APRIL 24TH, 2010.
________________________________Signature
Return Entry Form to: Make checks payable to: Shawna Mendelson
7 CARDINAL CT WYANDANCH NY 11798 * [email protected] ([email protected]) Phone 516 993-6378
May have some special guests putting up some crazy numbers!!
2010 APF NEW YORK STATE RECORD BREAKER
FULL POWER CHAMPIONSHIPS
APRIL 24TH, 2010
SPONSORED BY:
APF NY STATE CHAIRMAN SHAWNA MENDELSON & CHRIS TAYLOR
[email protected]
EVENT LOCATION: WORLD GYM
207 LITTLE EAST NECK ROAD,
WEST BABYLON NY 11704
www.worldpowerliftingcongress.com
516-993-6378
HOST HOTEL: TBD
ELIGIBILITY: Open to all APF registered athletes. 60 lifters Maximum
WEIGH-IN: WORLD GYM
24 hour weigh in rule will apply.
Friday April 23rd 11:00am - 4:00 pm
Saturday April 24th 8:00 am – 10:00am
COMPETITION: Mandatory rules briefing Saturday at 10:30 am
LIFTING SCHEDULE: Saturday April 24th Meet Starts at 11am Sharp!
UNIFORM: Mandatory - Must have one piece lifting suit or wrestling suit.
APF Rules apply.
CONTEST LIFTS: Squat - Bench Press – Deadlift and/or Bench Press Only
ENTRY FEE: A fee of $100 must accompany this entry form and be received no later than April 17th, 2010. $50.00 late fee for any entries allowed in after the deadline.
AWARDS: 1-3rd place and Best Lifter in each category based on content of entries.
2010 APF NEW YORK STATE RECORD BREAKER
FULL POWER CHAMPIONSHIPS
APRIL 24th, 2010
Entry Form
Competitor:
Last Name First Name MI
Address __________________________________________________ _______________________
City _________________________________ State ____________ Zip Code _________________
Home Phone _______________________ Work Phone ______________________ Age ________
e-mail ___________________________________________ Date of Birth _____________________
Division Entered: □Open □Junior 20-23 □Teen13-15 □16-17 □18-19 □Submaster 33-39
□Masters 40-44 □45-49 □50-54 □55-59 □60-64 □65-69 □70-74 □75-79 □80-84
□ Police/Fire/Military
Class Entered Men: 114 123 132 148 165 181 198 220 242 275 308 SHW
Class Entered Women: 97 105 114 123 132 148 165 181 198 Unl
Men □ Women□ Wt Class____________ □Powerlifting □Bench Press □Both (must lift in both)
Fees & Payment:
Late fee after 4/17/2010 $50 $___________
APF# _________ Exp. Date __________
Entry fee Powerlifting $100 $___________
Entry Fee Bench $70 $___________
TOTAL DUE $___________
Paid: □Cash □ Check
Waiver:
In consideration of the acceptance of this entry, I hereby for myself, my heirs, executors, and administrators waive and release any and all rights and claims for damages I may have against the APF, AAPF, Shawna Mendelson, WORLD GYM Inc. their representatives, successors, and assigns for any and all injuries or bodily harm that I might suffer while competing at the 2010 APF NY State Championships, APRIL 24TH, 2010.
________________________________Signature
Return Entry Form to: Make checks payable to: Shawna Mendelson
7 CARDINAL CT WYANDANCH NY 11798 * [email protected] ([email protected]) Phone 516 993-6378