Irondawg International Cup
February 24, 2018
Titanz Fitness of Northeast Georgia

280 Banks Crossing Drive
Commerce, Ga. 30529

Name____________________________________________________________

Address__________________________________________________________

City _______________________State__________Zip______________________

Phone________________________________ Birth date____________________

Email____________________________________________________________

Check all appropriate categories in each column below:

GPA Raw___                  IPO Equipped____

__Powerlifting Meet

__Bench Meet

---Deadlift Meet

__Pushpull Meet

__Team Entry

Team Name:
___________

___Open

Teenage:
___13-15
___16-17
___18-19

___Junior 20-23 

___Sub-master 35-39

Master:

____40-44
____45-49
____50-54
____55-59
____60-64
____65-69
____70-74
____75-79
____80-84
____85-89

Weight Class: Women:
__44Kg
__48Kg
__52Kg
__56Kg
__60Kg
__67.5Kg
__75Kg
__82.5Kg
__90Kg
__100Kg

__100+kg

 


Men:
___52Kg
___56Kg
___60Kg
___67.5Kg
___75Kg
___82.5Kg
___90Kg
___100Kg
___110Kg
___125Kg
___140Kg
___140+Kg

Release from Liability.  Read this carefully:  By signing this you will be giving up important rights.  In consideration of my acceptance of my entry form in this powerlifting competition, I understand that I am legally bound for not only myself but also for my heirs, my executors, and my administrators.   In signing this release form liability I waive and release L B Baker, Svetlana Baker, Irondawg Power, Inc., Titanz Fitness of Northeast Georgia, all Officials, Referees, Spotter/Loaders and any other persons or firms taking part in this competition from any liability which may arise from this competition.  I understand all the above for my acceptance of my entry in this competition.  By signing this entry form I affirm that all the information on this form is correct.

Signature______________________________________________   APC Card Number_______________

Parent or guardian if under 18________________________________________

Pushpull Competition $90.00-Bench Competition $80.00- Deadlift Competition $80.00.
Pushpull Competition and Bench Competition $150.00.
Pushpull Competition and Deadlift Competition $150.00.  All 3 Competitions $210.00
Team entry $50.00 per team

Make Checks payable to Irondawg Power.  Mail to:  P O Box 40, Bogart, Ga. 30622

 

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