Kentucky State & Midwest Regional
Registration Form
Meet Venue: National Guard Armory, 26 Armory Road, Prestonsburg, Kentucky
When: Saturday April 27, 2024
Meet Hosts: Jacob Goble, East Kentucky Barbell Phone: (606) 478-3200
365 SWPF Chairman & Meet Director: Bill Clary
Sanction by: 365 Strong World Powerlifting Federation (365 SWPF)
*Separate Events: >KENTUCKY STATE MEET >MIDWEST REGIONAL
Men & Women Division Category: >"Tested" (subject to drug test) or >"Untested" (no drug test given)
Featured Competition: FULL POWER, PUSH PULL, SQUAT ONLY, BENCH ONLY, DEADLIFT ONLY & STRICT CURL ONLY
Early Weigh–Ins: Friday, April 26, 2024: 9:30am – 12:00pm and 4:00pm – 6:00pm (at East Kentucky Barbell, 146 Conn Street, Ste 3, Ivel, KY)
Late Weigh-ins: Saturday, April 27, 2024: 7:00am-8:00am (by request only, held at National Guard Armory)
Eligibility: Open to all athletes. 18 and under lifters must have parental approval.
Membership: (at 365strong.org) Apply online for your VIP Lifetime or Annual Membership.
Event Criteria: The Kentucky State meet is only open to all Kentucky residence, the Midwest Regional is open to any athlete living in or out of Kentucky. Kentucky State entries may crossover to enter both.
Standard Full Power Entry Fee: $110 for one division
Full Power Military, Law Enforcement, Fire Fighters, Teens, Special Olympians and Push Pull, SQT, BP and DL Only Entry Fee: $95 for one division
Crossover and/or Standing Curl Fee: The "Crossover" and/or Standing Curl fee: $50
Deadline/Late Entries: All Entries MUST be received by April 13, 2024 or be charged a Late Entry Fee of $25. NO ENTRIES accepted the WEEK OF the MEET
Uniform: Mandatory - Must have one piece lifting suit or wrestling singlet. 365 SWPF rules apply @ 365strong.org.
Mandatory rules briefing: Saturday @ 8:00am; Lifting Begins at approximately 9am (upon completion of warmups and Opening Ceremonies)
Awards: 1-3rd place all Division Weight Classes, formulas are used for naming the Best Male & Female Lifters
Meet Flight 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 send in the event Registration Form and pay via PayPal; Payment by Cash App or Venmo are permitted upon request. Mail Check Made Out to: “365 STRONG”, PO Box 253, Fort Mill, SC 29716
Contact Numbers: 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 2024 Kentucky State and Midwest Regional, Sanctioned by 365 Strong World 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 host Jacob Goble, 365 SWPF President Bill Clary, 365 STRONG Powerlifting Federation LLC, East Kentucky Barbell, Prestonsburg, KY, Prestonsburg National Guard Armory, any property representatives, all 365 SWPF 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.