Kahle's Gym Powerlifting Championships

July 10, 2010

Sponsored by Kahle’s Gym

Date: Saturday, July 10, 2010, Lifting begins at 10 am.

Meet Director- Rich Kahle liftbigweights@hotmail.com or call 575-644-5415

Official Weigh-In Times

meet. Adult Cards $30.00 and High School Lifters are $15.00 per year. All lifters

as of 1.1.07.

No supportive suits or shirts allowed.

Supportive Equipment is Allowed except a 4” Lifting Belt. One piece Lifting Suits MUST be

DL or Full meet.

for Squat, Bench Press and Deadlift. All Canvas and Open Back Shirts are Illegal in NASA.

Wraps and Belt.

Men’s Weight Classes

114, 123, 132, 148, 165, 181, 198, 220, 242, 275, 308 & SHW

Women’s Weight Class

97, 105, 114, 123, 132, 148, 165, 181, 198 & 198+

Powerlifting and Power Sports Contests.

Definitions - Equipment Allowed

allowed.

No Supportive Suits and/or BP Shirts allowed.

Meet. Lifters may enter any event individually. No Supportive Equipment is Allowed

except a 4” Lifting Belt. One piece Lifting Suits MUST be worn. You may enter any event

as a single lift event, i.e.-Curl, BP, Squat, DL or Full meet in any division(s) you are

qualified, i.e. Masters-1, Novice, Pure, Open, etc.

No Canvas

Return Entry and Entry Fee’s

Rich Kahle, 1912 Bromilow St, Las Cruces, NM 88001

Entry Fee’s For All Events

entries. All Current High School Lifter’s entries are $40.00

Full Meet (Curl, BP & DL=Total) = $50.00

Strict Curl Only= $50, Bench Only=$55.00, Deadlift Only= $55.00

Combination of Any Two Power Sports Events= $85.00

Any 3 Individual Power Sports Events=$115.00 Any 3 Individual Power Sports Events = $130.00

Team Entry Fee

$40.00 per Team Entry. This fee is for the Team Trophy. Team Rosters MUST be turned in by the

start of

Teams.

Maximum of 10 members per team.

(Official NASA Entry Form)

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Late Fee Begins: July 1, 2010

Name:________________________________ Weight Class:________ Age:_____

Address:____________________________ City:_________________ St:___

Zip:__________

E-mail Address:_____________________________ Phone: (____)_______________

Full Equipped Powerlifting Meet Divisions Entered: _____, _____, _____, _____

Full Unequipped Powerlifting: _____, _____, _____, _____

Unequipped Bench Press: _____, _____, _____, _____

Bench Press Only (equipment allowed):_____, _____, ______, ______, ______

Push Pull Events Only- - _____, ______, ______, ______

Total Amount Enclosed : $_______ Check #_______ Total Number of

Divisions Entered:____

I realize this Competition is an Anabolic Steroid Free Meet and I may be Tested by Urinalysis

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 Kahle, NASA Powerlifting, Vista Middle School &

the school district, the facility used and any 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 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. Do Not Sign This Waiver Before Reading It Fully and Carefully. If you do

not accept it’s terms, DO NOT sign it.

Athlete’s Signature:_____________________________________ Date:__________

Parent’s Signature if Athlete is under 18 years of age:____________________________ Date