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COPYRIGHT 2012  IRON BOY ENTERPRISES   KEITH PAYNE

On-Line  Event Registration

Registration Steps:

>1. Complete Form   >2. Submit Form   >3. Submit Payment

I agree to the above waiver

Date of Birth:

Are you a member of IBP?

(If not, you will need to purchase a   membership at the meet.)

What weight class are you entering.

What  event and division are you entering?

I agree to the above waiver

Crossover

2013 IBP NATIONALS

Guardian's Initials

Adult     Full Power , Push Pull, Bench Only, Deadlift Only     

Youth/Teen    Full Power , Push Pull, Bench Only, Deadlift Only  

I - Division   $75

2 - Divisions  $130

I - Division   $35

2 - Divisions  $70

You must be an IBP member to lift at this meet. ($25 adult, $15 student) Cards will be available for purchase at the meet.

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Submit Payment after submitting registration.

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MaleFemale

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YYYY1925192619271928192919301931193219331934193519361937193819391940194119421943194419451946194719481949195019511952195319541955195619571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000

YESNO

Male66778897105114123132148165181198220242275308308+

Female66778897105114123132148165181198198+

Please Select-Youth 6-7Youth 8-9Youth 10-11Teen 12-13Teen 14-15Teen 16-17Teen 18-19Junior 20-23Intermediate 24-34Submaster (35-39) OpenPolice/ Fire / MilitaryMaster 40-44Master 45-49Master 50-54Master 55-59Master 60-64Master 65-69Master 70-74Master 75-79

In consideration of my acceptance of this entry, I hereby for myself, executors, and administrators waive and release all rights and claims for damage or injury which I may incur by virtue of my competing in this Iron Boy Powerlifting contest as against Keith Payne, event volunteers or sponsors. I also realize that the sport of Powerlifting is a high-risk sport, and I could be injured. I certify that I am in good health and have no serious health problems, and assume full responsibility for such condition.  In addition, I waive all rights to any pictures/ video taken at this event. I have read and fully understand the waiver and assume all risk for injury, and do here by verify by placing a check in the  box.

Minor’s RELEASE AND I, THE MINOR’S PARENT AND/OR LEGAL GUARDIAN, UNDERSTAND THE NATURE OF ATHLETIC ACTIVITIES AND THE MINOR’S EXPERIENCE AND CAPABILITIES AND BELIEVE THE MINOR TO BE QUALIFIED, IN GOOD HEALTH, AND IN PROPER PHYSICAL CONDITION TO PARTICIPATE IN SUCH ACTIVITY. I HEREBY RELEASE, DISCHARGE, COVENANT NOT TO SUE, AND AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS EACH OF THE RELEASEE’S FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON THE MINOR’S ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE “RELEASEES” OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATIONS AND FURTHER AGREE THAT IF, DESPITE THIS RELEASE.  I THE MINOR OR ANYONE ON THE MINOR’S BEHALF MAKES A CLAIM AGAINST ANY OF THE RELEASEES NAME ABOVE, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF THE RELEASEES FROM ANY LITIGATION EXPENSES, ATTORNEY FEES, LOSS LIABILITY, DAMAGE, OR COST ANY MAY INCUR AS THE RESULT OF ANY SUCH CLAIM.

RAWEQUIPPED

Please Select-Youth 6-7Youth 8-9Youth 10-11Teen 12-13Teen 14-15Teen 16-17Teen 18-19Junior 20-23Intermediate 24-34Submaster (35-39) OpenPolice/ Fire / MilitaryMaster 40-44Master 45-49Master 50-54Master 55-59Master 60-64Master 65-69Master 70-74Master 75-79

Full Power

Full Power

Push PullBench OnlyDeadlift Only

Push PullBench OnlyDeadlift Only