Ohio State Powerlifting

Step 1

Fill Out the entry Form Below and click "SUBMIT"

   NASA Ohio State PayPal Entry Form Only - All Credit Cards Accepted

Late Fee's Begin April 9th, 2012

    First Name-    Last Name-

    Wt. Class-   Age-   DOB-     Phone-

   Address- City-

   State- Zip-        E-mail Address-

    Equipped Powerlifting Division(s) Entered (i.e. Pure, Open, M-1 etc)-,

   Unequipped Powerlifting Division(s) Entered- ,

    Equipped Bench Only Division(s) Entered (i.e. Pure, Open, M-1 etc) -,

   Unequipped Bench Only (wraps & belt allowed) - ,

     Power Sports Full Meet Division(s) Entered (i.e. Pure, Open, M-1 etc) - ,

    Power Sports Individual Lift Division(s) Entered (i.e. Curl-M1, BP Pure, etc) - ,

    Push Pull Divisions Entered (i.e. Pure, Open, M-1 etc)- ,

    Grand Total Number of Divisions Entering-

    Total Amount of Entry Fees -$   (Don't forget to pay by PayPal below the Submit Button or call in your Credit Card info)

    You MUST submit this entry along with the PayPal Payment below to be entered in this meet. To pay by Credit Card without PayPal you must submit this entry form and then call 1-405-527-8513 to give credit card info by phone.

Comments or Questions-

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

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, Quality Inn Hotel Springfield Ohio, 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.

I agree to the terms of this waiver 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)-

I will be paying by the following method -

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Entry Fee's

Enter All Divisions You Are Entering - Be Specific, i.e. Masters-1, Novice, Open, etc.

Lifting will begin at 10:00 am Saturday

Men’s Weight Classes

Women’s Weight Classes

Return Entry and Entry Fee’s

Entry Fee’s: “Power Sports” Raw, Totally Unequipped - Full Meet

Entry Fees: Power Sports INDIVIDUAL Events - Awards in Each Individual Event Entered

Team Entry Fee