Holiday Powerlifting Classic
Meet Registration Form
Qualifying event for the 2022 USA Nationals!!
Event Host:
Rise Indoor Sports Complex-Torque Performance, 419 Twins Way, Advance, NC
Event Contact Phone #: (704) 236-1899
Event Date:
Saturday December 18, 2021
Federation President:
Bill Clary
Sanction by:
365 Strong World Powerlifting Federation (365 SWPF)
Division Classifications:
Drug “Tested” (Drug test consent) or “Untested” (No drug test)
Divisions: >Open >Juniors
(20-23)
>Novice
(Class II or below or newbie)
>Submasters
(35-39)
>Masters
(40-44, 45-49, etc.)
>Teenage
(13-15, 16-17, 18-19)
>M/P/F
>
Youth
(11-12)
>Para-Lifter >Kids Club
(10 & under)
Competition:
>Full Power >Push Pull >Squat Only >Bench Only >Deadlift Only >Strict Curl
Gear Categories:
>Raw
(wrist wraps/knee sleeves)
>Raw Classic
(wrist & knee wraps)
>Single-Ply >Multi-Ply
Weigh-in Location:
Rise Indoor Sports Complex
Early Weigh–Ins:
Friday December 17, 2021: 10:30am – 12:30pm and 4:00pm – 6:00pm
Late Weigh-Ins
(advanced approval necessary)
:
December 18th (Meet Day) from 7:00-8:00am
Eligibility:
Open to all lifting competitors, current or new members. Types of memberships,
Lifetime Membership
(one time fee) is
$55
and the year to year
Annual Membership
is
$30
per year.
Standard Full Power Entry Fee:
$100
M/P/F, Para-Lifters, Youth & Teen Full Power and Push Pull, Squat, Bench & Deadlift Only Entry Fee:
$85
Crossover or Strict Curl Fee:
$50
per additional Division
Team Entry Fee:
$60
(minimum 5 per team, maximum 11 per team with 2 alternates)
Deadline/Late Entries:
All Entries MUST be received by December 4, 2021 or be charged a
Late Entry Fee
of
$50
. No lifter registration permitted after December 9th or once we reach a maximum limit of 48 lifters! REGISTER EARLY TO LOCK IN ROSTER SPOT!!
Uniform:
Mandatory - Must have one piece lifting suit or wrestling singlet. 365 SWPF rules apply @ 365strong.org.
Agenda:
Mandatory rules briefing is Saturday @ 8:00 am; Lifting begins at approximately 9:00am
Awards:
1st thru 3rd place for each division and weight class. Best Lifter and Team awards.
Methods of Payment:
PayPal Online Payment (preferred): 365strong.org go to the meet event page or mail check or money order to "365 Strong Powerlifting" at PO Box 253, Fort Mill, SC 29716
Event Contact Numbers:
Bill Clary: (704) 236-1899
Federation Website / Email:
Website:
www.365strong.org
and Email: info@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 the
Holiday Powerlifting Classic
, Sanctioned by the 365 SWPF, 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 illness or hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the 365 SWPF 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 Director/Promoter Bill Clary, 365 Strong World Powerlifting Federation, Rise Indoor Sports & Torque Performance Fitness, facility coordinator Adam Barber, all facility personnel, 365 SWPF officers, officials, 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, ILLNESS, 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.
FOR PARENTS/GUARDIANS OF PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT TIME OF REGISTRATION) This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releases, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releases from any and all liabilities incident to my minor child's involvement or participation in these programs as provided above, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law.
Name
Address:
City, State, Zip:
Email
Phone
Other Phone
Date of Birth:
Home (Team) Gym:
Competitive Highlight:
Records:
Membership Status:
Enter Yes (you applied today) or No (you will apply at weigh-ins)
Classification Entered:
Enter "Tested" or "Untested"
Lifting Preference:
You may change your preference at weigh-ins.
Raw (knee sleeves permitted)
Raw Classic (knee wraps permitted)
Equipped Single-Ply
Unlimited Geared Multi-Ply
Division Categories:
What FULL POWER categories do you plan to enter:
Open
Juniors (20-23)
Novice
Submasters (35-39)
Masters
M/P/F
Teenage (13-19)
Youth (11-12)
Para-Lifter
Kids Club (10 & under)
Competition:
Full Power (squat, bench, deadlift)
Push Pull (bench & deadlift)
Squat Only
Bench Only
Deadlift Only
Strict Curl
Men's Weight Class Entering:
114.5lb/52kg
123.5lb/56kg
132.25lb/60kg
148.75lb/67.5kg
165.25lb/75kg
181.75lb/82.5kg
198.25lb/90kg
220.25lb/100kg
242.5lb/110kg
275.5lb/125kg
308.75lb/140kg
SHW-308.8+lb/140.1+kg
Women's Weight Class Entering:
97.0lb/44kg
105.75lb/48kg
114.5lb/52kg
123.5lb/56kg
132.25lb/60kg
148.75lb/67.5kg
165.25lb/75kg
181.75lb/82.5kg
198.25lb/90kg
SHW-198.3+lb/90.1+kg
I agree to abide by all terms of the Entry Information and the Waiver General Release:
YES
NO
Meet T-Shirt Size:
Adult S
Adult M
Adult L
Adult XL
Adult XXL
Adult XXXL
Adult XXXXL
Kids Club (enter shirt size in comments)
Walk-up Lifting Song
Please provide the name of your song and artist.
Lifter Name Confirmation
Parent or Guardian Approval (if under 18 years old)
Comments
Please provide the name of your song and artist.
Register