Sanctioned ENTRY

Event Time:

July 12th, 9:00am – 5:00pm

Event Address:

ZeroW Brisbane

(203 Lutwyche Road, Windsor)

ENTRY FEE: $130

Event Time:

July 12th,

9:00am – 5:00pm

Event Address: ZeroW Brisbane

(203 Lutwyche Road, Windsor)

ENTRY FEE: $130

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Test or Untested *

Tested
Untested

APL Membership ID *

First Name *

Last Name *

Email *

Phone *

Gender *

Equipment *

Sleeves
Wraps
Single Ply

Event *

SBD
Bench Only
Deadlift

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 agree to the Terms and Conditions of Participant Waiver and Release of Liability *

By checking this box I agree to the terms and conditions of Participant Waiver and Release of Liability

View Participant Waiver and Release of Liability

I agree to the APL Drug Testing Policy *

By checking this box I agree to the APL Drug Testing Policy

View APL Drug Testing Policy

I confirm that I am over the age of 18 and that all information provided is accurate. If the lifter is under 18, I confirm that I am the parent or guardian and will be present for the duration of the event while my minor is participating. *

By checking this box I confirm that I am over the age of 18 and that all information provided is accurate. If the lifter is under 18, I confirm that I am the parent or guardian and will be present for the duration of the event while my minor is participating.

I understand that this is a no refund event *

I understand that this is a no refund event.

Sanctioned Entry *

Price: $130.00

Square *

Card

Name on Card

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