WUAP – United Powerlifter
World Cup 2010
November
26.-28.; Eilenburg, Germany
Entryform
Lastname:................................... Firstname:
.............................................
Adress:
....................................... City/Country: .........................................
Birthdate:
____/_____/_______ Age: _________
Day
Month Year
Sex: □ female □
male
Weightclass:
48 52 only 56 60 67,5 75 82,5 90 90+ only 100 110 125
140 140+
□
□ woman □
□ □ □ □ □ woman □ □ □ □ □
Agecategorie:
Teenager Junior Open Submaster
Masters
□
16-17,
□ 18-19 □ 20-23 □ □
35-39
□
Entryfee: Benchpress:
□ € 70,- Powerlifting:
□ € 70,-
Powerlifting/Benchpress: □ € 120,-
(Please mark)
Deadline for the
entryform and fee: November 5. 2010 (late
entries – additional € 50)
With
the nomination the athlete accepts the rules of the federation "United
Powerlifter" and is
automatically
an extraordinarily member of the federation. 10% of the participating athletes
will be
tested
if they are drug free. If somebody should be positive, he/she will be excluded
from the meeting;
the
entry fee will be not returned. The result of the test is final.
Release from
Liability. Read this carefully.
By signing
this you will be giving up important rights. In consideration of my 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 the promoter and the whole 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 the
information on this form is correct.
Signature:
_________________________ Date: _____________________
Parent
or guardian if under 18:_______________________________
Please
send back to: Any questions?
Marcel
Mette
Roeberstrasse 4a; 04838 Eilenburg; GERMANY
mamette@gmx.de
Bank
wire: Kraft & Fitness Eilenburg
Sparkasse
Leipzig, bank account: 1070
0179 61
BIC CODE: WELADE8LXXX
IBAN
CODE: DE17 8605 5592
1070 0179 61
Please note your
name on the deposit.
Info:
United Powerlifter: www.united-powerlifter.eu.tf
www.kraft-fitness-eilenburg.de/homepage/weltcup2010.htm