SANCTIONED ENTRY

Event Timing:

Sunday August 4th, 8:00am – 5:00pm

Event Address:

Ground ZeroW

(4/36 Newheath Dr, Arundel QLD 4214)

ENTRY FEE: $130

*THIS IS A NON-REFUNDABLE EVENT

Event Timing:

Sunday August 4th, 8:00am – 5:00pm

Event Address: Ground ZeroW

(4/36 Newheath Dr, Arundel QLD 4214)

ENTRY FEE: $130

*THIS IS A NON-REFUNDABLE EVENT

APL Membership ID *

First Name *

Last Name *

Email *

Phone *

Gender *

Tested or Open *

Tested
Open

Equipment *

Sleeves
Wraps
Single Ply

Event *

SBD
Bench Only
Deadlift Only

Age

Weight Class (in KG) *

Male: 56
Male: 60
Male: 67.5
Male: 75
Male: 82.5
Male: 90
Male: 100
Male: 110
Male: 125
Male: 140
Male: 140+
Female: 44
Female: 48
Female: 52
Female: 56
Female: 60
Female: 67.5
Female: 75
Female: 82.5
Female: 90
Female: 100
Female: 110
Female: 110+

Next of kin name *

Next of kin phone number *

I voluntarily and knowingly accept the risk of injury inherent in my participation in this event. I certify that I am 18 years of age or older, or that I am the parent/guardian of the participant competing and that I have read this document and fully understand it. SIGNATURE: *

By checking this box I agree to the terms and conditions of this form

Sanctioned Entry *

Price: $130.00

Add Photo Package?

Yes - $50.00

PAYMENT INFO *

Card

Name on Card

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