American
Powerlifting Federation
SAM
HOUSTON OPEN
Powerlifting Championships
Powerlifting, Squat,
Bench Press, and Deadlift
Saturday December 9,
2006 -
Lifting starts at 11AM,
Weigh-ins: 9:00AM-10:00AM or Friday 5:30PM-7PM
Place: Sam Houston High School, 9400 Irvington
Blvd., Houston, Texas 77076
Information: Tom McCullough - 713-907-8129 - email:
tom_mccullough@texaspowerscene.com
Entry Deadline: Entries must be postmarked no
late
than Navember 25 ,
2006.
Late entries may or may not receive a trophy meet day and a $25
shipping fee
will be added in order to get the trophy to you.
Entries are non-refundable
The Monolift will be used in the squat and the Okie deadlift bar will
be used in the deadlift.
PLEASE
REGISTER EARLY! IT SAVES YOU MONEY AND
HELPS US PLAN AND
ORGANIZE AHEAD
Absolutely NO personal checks accepted
Men's Weight Classes: 114, 123, 132,
148, 165, 181, 198,
220, 242,
275,
308, SHW
Women's Weight Classes: 97, 105, 114, 123, 132, 148, 165, 181, 198, UNL
Powerlifting
Meet: $50
$40 extra divisions
|
Bench Press Division: $50
$40
extra divisions
|
Deadlift Division: $50
$40
extra divisions
|
Open
|
Open |
Open |
Teenage
|
Teenage
|
Teenage
|
Junior 20-23
|
Junior 20-23
|
Junior 20-23
|
Submaster 33-39
|
Submaster 33-39
|
Submaster 33-39
|
| Master 40+ |
Master 40+
|
Master 40+
|
Sanction: This
event is sanctioned by the APF.
Membership is mandatory and membership cards may be purchased at the
meet. $30 yr for adults & $15 yr for tennagers.
MAIL ALL ENTRY FORMS AND MONEY
ORDERS PAYABLE TO:
Tom McCullough
16003 Sandy Path Lane
Houston,
Texas 77084
Official Entry Form APF Sam Houston Open Powerlifting
Championships
Last
Name:_______________________________________First
Name:__________________________________MI:________________
Address
__________________________________________________________
e-mail ________________________________________
City
___________________________________________________State
___________________ Zip Code________________________
Home Phone
_______________________________________Work Phone
____________________________________ Age__________
Occupation
_________________________________ Sponsor(s)
_____________________________________ Date of Birth__________
Event
Entered: Powerlifting Meet___ Bench Meet ___ Deadlifting Meet___
Division Entered: Men's Open ___
Women's Open ___ Men's Jr./Teen ___ Men's Masters ___
Wt Class: 114 _ 132 _ 148 _ 165
_ 181 _ 198 _ 220 _ 242 _ 275 _
308 _ï€
SHW _
APF# _________ Exp. Date
__________
Powerlifting Meet
entry fee $50
_$___________
Bench Meet entry fee
$50
_$___________
Deadlift Meet entry
fee $50
_$___________
Add $40 each add'l
division
_$___________
TOTAL DUE _$___________
LIABILITY
WAIVER
By
virtue of the acceptance of this entry I hereby waive and forever
release all
claim for injury, damages or personal loss which the above lifter might
suffer at the APF Sam
Houston Open Powerlifting Championships. I
forever
release Sam
Houston High School,
Houston ISD, the American Powerlifting Federation, and
employees,
representatives, meet directors and officials, and volunteer workers of
the
American Powerlifting Federation , Sam Houston High School, and Houston ISD
from any claim of damages for injury, damage, or personal loss. I understand that powerlifting can be a
dangerous sport and injuries can do result in sports. My signature
below
indicates
that I have read and understand this document.
Signature
of Lifter or Parent / Legal
Gaurdian__________________________________________________________________Date_________________________________
