2014 Raw Unity Qualifier #1
Powerlifting Championships
August 2nd, 2014
MEET DIRECTOR:
Eric Talmant:
EVENT LOCATION:
Stronglife Tampa Bay
5115 West Knox ST.
Tampa, FL 33634
HOTEL:
TBD
WEIGH-IN:
erictalmant@yahoo.com
Friday, August 1st:
Saturday, August 2nd:
9:00 am – 8:00 pm
8:00 am – 8:30 am
.
EVENT START TIME:
9 am Saturday, August 2nd
ENTRY DEADLINE:
SATURDAY, JULY 12TH, 2014
UNIFORM:
Mandatory - You must have a one-piece singlet or wrestling suit. Wrist
wraps, belt, and NEOPRENE knee sleeves optional. A list of the approved
neoprene knee sleeves can be found at:
http://www.powerliftingwatch.com/files/List%20of%20Approved%20Knee%20Slee
ves.pdf
OR You must have a one-piece singlet or wrestling suit. Wrist wraps, belt,
and up to 2.5 meter knee wraps optional.
Lifters of All Experience Levels are welcome to compete! Those
attempting to qualify for RUM 8 can find the qualifying totals in the Raw
Unity Facebook Group Page or here: RUM 8 QT's or by emailing me for
them at erictalmant@yahoo.com
CONTEST LIFTS:
Full Power (Squat+Bench+Deadlift) and Bench Only.
ENTRY FEE:
The entry fee for the full power or bench only is $65. Combined is $85.
The entry fee must accompany this entry form and be received (not
postmarked by) on or before Saturday, July 12th, 2014—EVEN IF you are
paying with PayPal. Entry forms still need to be filled out, signed, and
mailed in (minus entry fee check) by July 12th if using PayPal. The
address to send PayPal payments as well as electronic entry forms is:
erictalmant@yahoo.com.
Entry forms will not be accepted after Saturday, July 12, 2014. NO
EXCEPTIONS. Refunds will be considered on a case by case basis.
We will take the first 60 lifters that sign up. First come, first served until all 60
spots are filled. There will be a morning and an afternoon session consisting
of roughly 30 lifters in each session. Each session will have 2 flights roughly
consisting of 15 lifters.
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Name: ___________________________________________________________________________
Address: ____________________________ City____________________ State_____ Zip_________
Phone: _____________________________ Email: ________________________________________
Weight Class: _______ Age: _________ Birth date: ______________ Male_______ Female_______
Events (Please circle):
Powerlifting KNEE SLEEVES
Powerlifting KNEE WRAPS
Bench Only
BOTH Full Power+Bench Only
Weight Class:
97□ 105□ 114□ 123□ 132□ 148□ 165□ 181□ 198□ 220□ 242□ 275□ 308□ SHW□
Fees & Payment:
Full Power/Bench Only: $ 65
$___________
BOTH Full Power+Bench Only: $ 85 $___________
Please return forms and make check or money order payable to:
Eric Talmant
612 Lakemont Drive
Brandon, FL 33510
Email: erictalmant@yahoo.com
Occupation/School:
________________________________________________________________
PARTICIPANT’S EMERGENCY
CONTACT INFORMATION
Name: _________________________________________________Relation: ____________________
RELEASE FROM LIABILITY Phone: ______________________
Address: ______________________________________________
IMPORTANT: READ THIS RELEASE CAREFULLY. WHEN YOU SIGN, YOU WILL BE GIVING UP
THESE ARE YOUR VERY IMPORTANT LEGAL RIGHTS:
In consideration of acceptance of my entry in the 2014 Raw Unity Meet Qualifier #1, I intend to be legally bound for not only myself,
but also for my heirs, my executors and my administrators. In signing this Release from Liability, I waive and release everyone
connected with the 2014 Raw Unity Meet Qualifier #1, including, but not limited to the meet directors, event staff, any sponsors, from
any and all liability, including any result of negligence which may arise from this competition.
I agree to pay any attorney fee and litigation expenses incurred by any person, real or corporate, whom I may sue in an effort to
challenge this Release from Liability form. I understand that my agreement to pay attorney fees and litigation expenses is the sine
qua non for the acceptance of my entry in this contest. If any provision of this Release from Liability shall be deemed by a court of
competent jurisdiction to be invalid, the remainder of this Release from Liability shall remain in full force and effect. I also certify with
my signature that this Release/Agreement cannot be modified, orally.
______________________________________________
Signature in full of Applicant
_________________________________________________
Signature in full of legal Guardian (if Applicant under 18 years)
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