Power in the Pines Entry Form
MEET DATE:  July 10, 2021
SANCTIONED BY:
365 Strong World Powerlifting Federation LLC (365 SWPF)
MEET HOST: Wongo's Barbell / Rob Walding   PH: (808) 754-3251 
LOCATION:  Carthage, NC
EARLY WEIGH-IN SCHEDULE (Friday July 9th): 10:30 am - 12:30 pm and 4:00 - 6:00 pm 
LATE WEIGH-IN (Saturday July 10th)7:00-8:00 am 
MANDITORY RULES MEETING:
  Begins @ 8:00am  Warm-up: Immediately after Rules Meeting.
MEET START TIME: At approximately 9:00am (depending on adequate warm-up time)
ELIGIBILITY: Open to any male or female age 11 years or older
RULES: See complete rules at www.365strong.org
LIFTING CATEGORIES: Select One:   RAW (Sleeves)   RAW CLASSIC (Knee Wraps)   EQUIPPED SINGLE-PLY   GEARED MULTI-PLY 
SEPARATE CLASSIFICATIONS:  "TESTED" or "UNTESTED"
DIVISIONS:
 >OPEN  >NOVICE  >JUNIORS (20-23)  >SUB-MASTERS (35-39)  >MASTERS  >M/P/F  >TEENAGE  >YOUTH  >PARA-LIFTER 
AREAS OF COMPETITION:  >FULL POWER  >PUSH PULL  >SQUAT ONLY  >BENCH ONLY  >DEADLIFT ONLY
AWARDS:  1-3 Place Awards for each classification weight class, Team Champion and Best Lifters 
MEMBERSHIP OPTIONS:  $55 VIP Lifetime (one-time pay) or $30 Annual (yearly renewal) 
STANDARD FULL POWER REGISTRATION FEE:  $100.00
REGISTRATION FEE FOR FULL POWER M/P/F, TEENS & YOUTH:  $85.00
REGISTRATION FEE FOR PUSH PULL and SQUAT, BENCH, DEADLIFT ONLY:  $85.00
CROSSOVER FEE:  $50.00 (when entering more than one division)
TEAM ENTRIES: $80.00, teams must consist of a minimum of 4 members, maximum of 11…plus 2 alternates.
EARLY ENTRY DEADLINE: Entries received after the July 1, 2021 deadline will be subject to paying an additional $50.00 late fee. No entries will be accepted the day of the meet!
365 SWPF PRESIDENT:  Bill Clary   
CONTACT INFO: Email – info@365strong.org, Address: PO Box 253, Fort Mill, SC 29716, PH: (704) 236-1899
ONLINE REGISTRATION: Go to our www.365strong.org website to “Upcoming Events” page and follow online registration instructions.
Male Weight Classes: 114½ 123½ 132¼ 148¾ 165¼ 181¾ 198¼ 220¼ 242½ 275½ 308¾ SHW
Female Weight Classes: 97.0 105¾ 114½ 123½ 132¼ 148¾ 165¼ 181¾ 198¼ Unlimited
DIVISIONAL SPLITS:  Open & M/P/F - Any Ages  Youth - ages 11-12  Teenage – Age Splits: 13-15 16-17 18-19  Juniors - ages 20-23  Sub-Masters - ages 35-39  Master – Age Splits: 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75+

RELEASE OF LIABILITY WAIVER (READ BEFORE SIGNING and return with entry form and fees) In consideration of being allowed to participate in any way in the 2021 Power in the Pines, Sanctioned by 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 hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the meet 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 Host – Rob Walding, 365 SWPF President - Bill Clary, all 365 SWPF personnel, 365 Strong World Powerlifting Federation LLC, Wongo's Barbell, all gym and meet personnel, meet referees, 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. 5. I willingly allow 365 Strong World Powerlifting Federation to use my photos or videos to promote my accomplishments and I approve the use of my photos or videos in federation marketing materials. 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. _________________________________________ ____________ ___________________ PARTICIPANT'S SIGNATURE AGE DATE 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. ______________________________________ ______________________ ____________ PARENT/GUARDIAN SIGNATURE PHONE DATE