Masters Powerlifting

Late Fee Begins 10-29-12

STEP - 1 Submit Entry Form

NASA Masters / Sub Masters Credit Card Entry Form Only

All PayPal entry payments (Step 2) MUST be made within 2 hours after submitting Entry Form

First Name- Last Name-

Wt. Class- Age- DOB- Phone-

Address- City-

State- Zip- E-mail Address-

    Equipped Powerlifting Division(s) Entered (i.e. 40-44, etc)-, ,

     Unequipped Powerlifting Divisions Entered - , ,

    Bench Only Division(s) Entered (i.e. 40-44, etc)-, ,

    Unequipped Bench Press Divisions Entered- , ,

    Power Sports© Full Meet Division(s) Entered (i.e. 45-49, 55-59, etc) -, ,

    Power Sports© Individual Events entered- (c-40-44, bpsmp, etc)- , ,

     Equipped Push Pull Divisions Entered (i.e. m-p, 50-54, etc)- ,

   Unequipped Push Pull Divisions Entered (i.e. m-p, 50-54, etc)- ,

    Grand Total Number of Divisions Entering-

    Total Entry Fees -$

I will be paying by the following method -

(Don't forget to pay by PayPal below in Step 2 or call in your Credit Card info to 405-527-8513)

You are NOT entered until your entry fee is paid!

If you would rather pay with PayPal's ultra secure payment system, proceed to Step 2

Comments or Questions-

Read this Waiver Completely Before Submitting - All Unsigned Entries Will Be Returned

I realize this is a Anabilic Steroid Free Meet and I MAY be Urine Tested at any time during this event

In consideration of your acceptance of this entry, I hereby waive, for myself, my heirs and assigns, any and all claims for injury or damages which I may incur by virtue of my competing in this contest as against Rich Peters, NASA LLC Powerlifting, NASA, Westwood High School and the Westwood School District, Walt Sword, any and all spotters & loaders, the facility used and any and all of their agents and employees. I also realize that the sport of Powerlifting is a high risk sport and that I could be injured. I certify that I am in good physical health and have no serious health problems and that I assume full responsibility for such conditions. I realize that if I use the False Grip or Open Grip that it is a dangerous method of BP'ing and I assume full responsibility if I choose to use this method to BP. I also agree to submit to drug testing at any time during this event if I am asked to do so. I certify that I know and understand completely the NASA policy for drug testing and NASA's use of it's coefficient system and agree to their policies. I also realize that I am fully responsible for my well being and safety in the warm up room, on the lifting platform and while I am lifting at this event. I also certify, by my signature, that I have read this waiver and fully understand and accept it’s terms. I do hereby verify my acceptance by my signature below. I also realize that children and non lifters are NOT allowed in the warm-up room for any reason. I also give NASA, Rich Peters and all other parties involved in this meet permission to post my name and make my name public if I fail any Drug Test.

Do Not Sign This Waiver Before Reading It Fully and Carefully. If you do not accept it’s terms, DO NOT sign it.

I agree to the terms of this waiver and the waiver posted above and on the written entry form and do so indicate by my submission this Credit Card Entry.

I Realize that this Competition is an Anabolic Steroid Free Meet
I to the terms of this waiver (Initials)-

Security Word - nasa101

Please type Security Word, nasa101, here-

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Step 2 - Pay by PayPal

Use this form if you are NOT paying by call-in credit card above. PayPal is an Ultra Secure payment system.

Payment MUST be made within 2 hours of the Entry Form submission

NOTICE: If you experience difficulty paying through PayPal, please try signing on using Internet Explorer. Some lifters who use Cox, Hotmail and Yahoo accounts have reported problems. If all else fails please PayPal your entry fee to this e-mail address Peterssales@aol.com

Official Weigh-In Times for All Lifters

Men’s Weight Classes

Women’s Weight Classes

Men’s & Women’s Age Divisions for Equipped Powerlifting, Unequipped Powerlifting, Equipped Bench Press Only, Unequipped Bench Press, Equipped Push Pull, Unequipped Push Pull, Power Sports (raw)

*Sub Masters Pure: 30-39 of age, Anabolic Steroid Free for Life.

*Masters Pure: 40+ years of age, Anabolic Steroid Free for Life.

Power Sports© (no equipment) Entry Fee’s Only - Use Credit Card Form below for ALL Power Sports© Entries.

Entry Fee’s - Use Credit Card Form below for ALL Masters Entries.

Return Entry and Entry Fee’s : NASA LLC, P.O. Box 735, Noble, OK. 73068 Or you may enter on-line from our web site.

Team Entry Fee : $50.00 per Team Entry. This fee is for the Team Trophy. Team Rosters MUST be turned in by the start of lifting on Saturday. Trophies for 1^st thru 3^rd for Powerlifting, BP Only and Power Sports Teams. Maximum of 10 members per team.