Midwest Regional Powerlifting Championship
Entry Registration Form

Where: Shady Gators Resort, 132 Sweet William Road, Lake Ozark, MO 65049
When: Saturday June 9, 2018  
Meet Hosts: Rick Streb & Rich McDowell
Co-National 365 Strong Chairmen & Meet Director: Bill Clary  
Sanction by: 365 STRONG Powerlifting Federation (365 SPF)  
Division Category:  Tested or Untested
Events: FULL POWER, PUSH PULL, BENCH ONLY, DEADLIFT ONLY
Weigh – Ins: Friday, June 8, 2018: 10:30am – 1:30pm and 3:30pm – 6:30pm or Saturday, June 9, 2018: 6:30am-7:45am 
Eligibility: Open to all lifting competitors 13 years of age and older. 18 and under lifters must have parental approval. 
Membership: (at 365strong.org) Apply online for only $45 for a lifetime membership or $30 annually.
Standard Full Power Entry Fee: $105 for one division and $50 for each additional Crossover division entered.  Bench, Deadlift & Push-Pull Only Entry Fee: $85
All Military, Law Enforcement, Fire Fighters, Teens and Special Olympians Full Power Entry Fee: $85 for one division and $50 Crossover Fee per additional Division 
Deadline/Late Entries: All Entries MUST be received by June 2, 2018 or be charged a Late Entry Fee of $50. NO ENTRIES accepted the WEEK OF the MEET
Uniform: Mandatory - Must have one piece lifting suit or wrestling singlet. 365 SPF rules apply @ 365strong.org.
Competition: Mandatory rules briefing: Saturday @ 8:15am; Lifting Begins at approximately 9am (upon completion of warmups and Opening Ceremonies) 
Awards: 1-3rd place all Divisions except when formulas are used for placement then it's 1-5 places and a Best Male & Female Lifter will be Named 
Meet Session Splits: Will be announced to all competitors the week of the event
Online Registration: Go to www.365strong.org website "Upcoming Events" page and follow instructions to pay via PayPal; or Mail Check Made Out to: “365 STRONG”, PO Box 253, Fort Mill, SC 29716
Contact Numbers: Rick Streb: 816.590.1191, Email-rick@prodiets.com,  Rich McDowell at benchbro@gmail.com or Bill Clary: 704.236.1899, Email: info@365strong.org  
Website: www.365strong.org  


RELEASE OF LIABILITY WAIVER (READ BEFORE SIGNING and return with entry form with entry fee)

In consideration of being allowed to participate in any way in the 2018 Midwest Regional Powerlifting Championships, Sanctioned by 365 Strong Powerlifting Federation, its related events and activities, I The undersigned, acknowledge, appreciate, and agree that: 1. The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular skills, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and, 2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and, 3. I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the 365 SPF officials immediately; and, 4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS THE Meet Directors Rick Streb & Rich McDowell, 365 SPF National Chairmen Bill Clary & Wayne VanNostrand, 365 STRONG Powerlifting Federation LLC, Shady Gators Resort of Lake of the Ozark, MO, any property representatives, all 365 SPF officers, meet referees, all event personnel, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used for the activity ("Releases"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.