2012 APF NEW YORK STATE
FULL POWER CHAMPIONSHIPS
March 24TH, 2012
SPONSORED BY: SHAWNA MENDELSON & TEAM BLUE COLLAR BARBELL
EVENT LOCATION: ALL NATURAL GYM
163 SOUTH 11TH STREET
ELIGIBILITY: Open to all APF registered athletes.
WEIGH-IN: ALL NATURAL GYM
24 hour weigh in rule will apply.
Friday - March 23rd 11:00am - 4:00 pm
Saturday March 24th 9:00 am – 10:00am
Meet will be Raw and Equipped!
COMPETITION: Mandatory rules briefing Saturday at 10:30 am
LIFTING SCHEDULE: Saturday March 24th. Meet will Start at 11am Sharp!
UNIFORM: Mandatory - Must have one piece lifting suit or wrestling singlet.
APF Rules apply.
CONTEST LIFTS: Squat - Bench Press – Deadlift and/or Bench Press Only
ENTRY FEE: $100 for the full meet, $80 for Push/Pull, $60.00 Bench only!
MARCH 19TH, 2012. $20.00 late fee for any entries allowed in after the deadline.
AWARDS: 1-3rd place and Best Lifter in each category based on content of entries.
2012 APF NEW YORK STATE RECORD BREAKER
FULL POWER CHAMPIONSHIPS
March 24th 2012
Last Name First Name MI
City _________________________________ State ____________ Zip Code _________________
Home Phone _______________________ Work Phone ______________________ Age ________
e-mail ___________________________________________ Date of Birth _____________________
Division Entered: □Open □Junior 20-23 □Teen13-15 □16-17 □18-19 □Submaster 33-39
□Masters 40-44 □45-49 □50-54 □55-59 □60-64 □65-69 □70-74 □75-79 □80-84
Class Entered Men: 114 123 132 148 165 181 198 220 242 275 308 SHW
Class Entered Women: 97 105 114 123 132 148 165 181 198 Unl
Men □ Women□ Wt Class____________ □Powerlifting □Bench Press □ Push/Pull (must lift in both)
Raw , Single Ply, Multiply Please circle!
Fees & Payment: Late fee after 3/19/2012 $20 $___________
AAPF# _________ Exp. Date __________
Entry fee Powerlifting $100 $___________
Entry Fee Push/ Pull $80 $___________
Entry Fee Bench Only $ 60 $___________
TOTAL DUE $___________
Paid: □Cash □ Money Order/Cashiers Check
In consideration of the acceptance of this entry, I hereby for myself, my heirs, executors, and administrators waive and release any and all rights and claims for damages I may have against the APF, AAPF, Shawna Mendelson, ALL NATURAL GYM, their representatives, successors, and assigns for any and all injuries or bodily harm that I might suffer while competing at the 2012 APF NY State Championships, MARCH 24TH, 2012.SIGN HERE X
RETURN ENTRY FORMS TO: MAKE CHECKS PAYABLE TO SHAWNA MENDELSON
ALL NATURAL GYM 163 SOUTH 11TH STREET LINDENHURST, NY (631) 957-7373