Summer Beast Registration 2021
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First Name *
Last Name *
Email Address *
Gender *
Age *
Date of Birth *
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Weight (lbs) *
Height (in) *
Phone Number 777-777-7777 *
Home Address *
Shirt Size *
First Attempt Bench Weight (if you know it... and you will be allowed to change this!)
First Attempt Deadlift Weight (if you know it, and you will be allowed to change this!)
First Attempt Squat Weight (if you know it, and you will be allowed to change this!)
Clear selection
********l*I UNDERSTAND THAT I MUST AGREE TO AND SIGN THE FOLLOWING WAIVER IN PERSON PRIOR TO COMPETING (MINORS MUST HAVE PARENT/GUARDIAN PRESENT TO SIGN)*******                                                                           In consideration of your accepting this entry, I hereby for myself and my heirs, release any & all rights for-damages for injuries I may have against WPAL DuBois Fitness Center, meet director Aaron Beatty, the City of DuBois, and any/all other meet associates, staff, spotters, loaders, all sponsors, referees as a result of my traveling to, and/or participating in the above listed competition. I make this release and waiver of claim with full knowledge of the hazards and inherent rights associated with the above listed competition. I hereby assume the risk of injury and property damage/loss.  Also, in consideration of accepting this entry I hereby sign over my rights to be videotaped and/or photographed, to the meet directors and/or his designee. I am fully aware that I will receive no royalties and/or compensation for resale of the videotapes and/or photos.                                                          RELEASE FROM LIABILITY AND CONSENT TO DRUG TEST.  IMPORTANT: READ THIS RELEASE CAREFULLY, BY SIGNING THIS FORM YOU WILL BE GIVING UP IMPORTANT LEGAL RIGHTS. In consideration of the acceptance of my entry in this Powerlifting competition I intend to be legally bound for not only myself, but also my heirs, my executors, and my administrators. In signing this release from liability I waive and release everyone connected with the competition from any and all liability, including any results of negligence which may arise from this competition. Moreover I agree that any testing method which the meet director and the sponsors of this meet use to detect the presence of strength-inducing drugs SHALL BE CONCLUSIVE. That is, whether I think results of the test are right or wrong I agree that I have no right to challenge the results of the drug test. I further agree to submit to any physical test, which may be necessary to complete drug testing. Should I fail to pass drug test, I agree to forfeit any trophies or awards. I otherwise have won. I understand and agree that if I fail to pass the drug test, my name will appear on a published list of suspended members. If it is determined that I have failed the drug test, I agree to waive any claim for which legal relief is available. I agree to pay any attorney fee and litigation expenses incurred by any person, real or corporate, whom I may sue in an effort to challenge this Release from liability form. I understand that my agreement to pay attorney fees and litigation expenses is the Sino Qua Non for the acceptance of my entry in this contest. I also certify with my signature that this release/agreement cannot be modified orally.  Certification: I hear give my word of honor as an athlete that I have not used any strength inducing drugs (i.e. anabolic steroid, natural hormone or synthetic growth hormones) as part of my training during the past 36 months, nor have I used prescription diuretics or psychomotor stimulants during the seven days prior to this meet. I also certify that the information regarding my qualifying total is accurate true information. To be signed by Lifter, Parent/Guardian or Coach if under age 18 *
Emergency Contact Name *
Emergency Contact Phone *
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