Meet Entry Form

Canadian Powerlifting Federation (CPF)(WPC Affiliate)

The meet will be hosted inside the gym at Montreal Barbell, 289b Boul Harwood, Vaudreuil-Dorion, Quebec,

Weigh in at meet site: Friday May 7, 9AM – 9PM & Saturday May 8, 7:30AM – 8AM for Saturday lifters, and

Saturday May 8, 10AM - 8PM & Sunday May 9, 8:00AM - 9AM for Sunday lifters.

Lifting starts at 9AM

Meet Director: Ross Saldan cell (941) 544 0781 Gym phone (450) 424 7220 Email: This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Meet Entry Fee: Please circle the category you wish to enter;

AMATEUR ADULTS – Full Power - $100; Bench, Deadlift or Ironman - $75. Teens - $60. 2^nd Category +$35.

PRO ADULTS – Full Power - $125; Bench - $100. 2^nd Category +$50.

Make check payable to: Ross Saldan.

Mail entry and check to Ross Saldan, 241 Rue Melville, Vaudreuil-Dorion, Quebec, Canada J7V 2B8

Number of competitors may be limited.

Entry Deadline is April 17, 2010. Entries received after April 17, may not be accepted, depending on space available.

Late Entries - add $35

Lifter Information:

Name: ___________________________ Age: _____ Birth Date: __________ E-Mail:______________________

Address: _________________________________City: ___________________________

Province / State : _____Postal / Zip Code: ___________

Home:(____)______________Work:(____)______________Cell:(____)_______________

T-shirt size: (please circle your size) 4x, 3x, 2x, xL, L, M, S

DIVISIONS (Men & Women) Please circle your age and weight categories below:

Teenage: 14-15, 16-17, 18-19; Junior: 20-23; Open: 24 and older; Sub master: 33-39

Master: 40-44, 45-49, 50-54, 55-59, 60-64, 65-69, 70-74, 75-79, 80+

Weight Classes (kg): Men: 52, 56, 60, 67.5, 75, 82.5, 90, 100, 110, 125, 140, 140+

Women: 48, 52, 56, 60, 67.5, 75, 82.5, 90, 90+

EQUIPMENT MUST MEET CPF, WPC, APF SPECIFICATIONS. ONE PIECE LIFTING SUIT MUST BE WORN

Awards will be given for 1^st, 2^nd, and 3^rd places.

RELEASE FROM LIABILITY

In consideration of the acceptance of my entry form in this power lifting competition, I intend to be legally bound

for not only myself, but also for my heirs, executors and administrators. In signing this release from liability, I wave

and release any and all rights or claims for damages I may have against the CPF, the WPC, the organizers,

volunteers or the sponsors of this contest.

Signature___________________________________________________Date___________________

Parents (if under 21 years) ___________________________________________________________