ADAU RAW POWER PENNSYLVANIA STATE POWERLIFTING CHAMPIONSHIPS

Transcription

1 ADAU RAW POWER PENNSYLVANIA STATE POWERLIFTING CHAMPIONSHIPS Saturday 8 May 0 Kumite Classic/FAST Expo ( Monroeville Convention Center 0 Mall Boulevard Monroeville, PA 546 Schedule: Friday, 7 May 0 (at the Kumite Classic/FAST Expo) 4:00 pm to 6:00 pm: Early weigh-in for all competitors. Saturday, 8 May 0 (at the Kumite Classic/FAST Expo) 7:00 am to 8:30 am: Regular weigh-in for all remaining competitors at competition site meet day. 8:30 am: Mandatory rules clinic. 9:5am: Competition begins. Open Entry Fee: $60.00 full powerlifting meet; $5.00--additional for any age group. Fees are not refundable. Limited to first 50 lifters. Check Kumite Classic/FAST Expo website for spectator admission fee, directions, and hotel info ( ALL LIFTERS MUST COMPETE IN THE OPEN DIVISION, BUT MAY ALSO COMPETE IN ANY AGE CATEGORY BY PAYING THE ADDITIONAL FEE FOR THAT DIVISION. One free meet t-shirt will be provided to all competitors. Team Entry Fee: $ Team roster must be submitted by May 0. Awards: Top 5 places in all men and women s classes in the open divisions; top 3 places in all age group classes. Age groups include all youth, juniors, sub-masters, and masters. Outstanding lifter awards in the open divisions only. Mail Entries to: Monsters Unlimited, 9456 Saltsburg Road, Pittsburgh, PA 539 (4) Deadline: Eligibility: Entries must be in the meet directors possession by May 0. No late entries will be accepted. Contest is open to any athlete with a current ADAU membership card. Membership cards may be purchased at the contest. All athletes must be drug free for a minimum of 60 months. Male Weight Classes (lbs): 4, 3, 3, 48, 65, 8, 98, 0, 4, 75, 39, over 39. Female Weight Classes (lbs): 97, 05, 4, 3, 3, 48, 65, 8, 98, over 98. Youth Weigh Classes (lbs): Uniform: 77, 88.97, 05 in addition to above weight classes. One-piece singlet non-supportive suit is required for all adults. 4 leather belt is allowed. Support gear (i.e., bench shirts, squat suits, deadlift suits, knee wraps, knee sleeves, wrist wraps) is not allowed. Ivanko calibrated kilogram weights will be used for this contest. (Kilo-to-Pounds Conversion Chart provided with this application; might consider tracking competitor lifts in kilograms/pounds using score sheet provided with this application). ***POWERLIFTING CAN BE DANGEROUS AND YOU LIFT AT YOUR OWN RISK, WITH NO ONE BEING RESPONSIBLE FOR ANY INJURY YOU MAY HAVE AS A RESULT OF COMPETING IN THIS MEET***

2 Entry Form ADAU RAW POWER PITTSBURGH POWERLIFTING CHAMPIONSHIPS Kumite Classic Sports & Fitness Expo 8 May 0 (This form must be filled out completely) Name Age Birth date Address City State Zip Code Phone Weight Class Male Female Address Emergency Contact Relation Phone Please enter me in: $60.00 Open Powerlifting Meet; $5.00 Age Group T-Shirt S M L XL XXL Team $40.00 Total Due Team Name Please make check or money order payable to: Monsters Unlimited; 9456 Saltsburg Rd, Pgh, PA 539 Athlete s Liability Release Form In consideration of the acceptance of my entry in this ADAU Powerlifting competition, I, intending to be legally bound, do hereby, for myself and my heirs, executors and administrators waive, release, accept the risk for, and forever discharge any and all rights and claims for damages which I may have, or which may hereafter accrue against the ADAU, Monsters Unlimited, the local hosts, facility owners, and other support organization, their respective officers, agents, representatives, members, employees, volunteers, and successors involved. Moreover, I agree that any testing method that the meet director and the sponsors of this meet use to detect the presence of strengthinducing drugs and controlled/banned substances shall be conclusive. That is, whether I think the results of the test are right or wrong, I agree that I have no right to challenge the results of the drug test. I further agree to submit to any physical test which may be necessary to complete the drug testing. Should I fail the drug test, I agree to waive any claim which might arise under state law for defamation, slander, libel, or any other claim for which legal relief is available. If it is determined that I have failed the drug test, I agree to forfeit any trophy or award which I might have otherwise won. Except during drug testing, I hereby authorize the ADAU, and /or its designated representatives to allow the reproduction, dissemination, and/or publication of my name and likeness for media coverage, public relations, or any other purpose which involves the use of photographs, films, video or audio tape recording. I AGREE THAT POWERLIFTING CAN BE DANGEROUS AND I LIFT AT MY OWN RISK, WITH NO ONE BEING RESPONSIBLE FOR ANY INJURY I MAY HAVE AS A RESULT OF COMPETING IN THIS MEET. I have carefully read all the above and I fully understand and agree with all of its contents. In acknowledgement thereof, I affix my signature hereunder. Athlete s Signature Guardian s Signature (if required) Drug Free Statement I hereby give my word of honor as an athlete that I have not used any strength-inducing drugs (INCLUDING BUT NOT LIMITED TO any anabolic steroid, natural hormone or synthetic hormone) as part of my training during the past 60 months ( 5 years), nor have I used any prescription diuretics or psychomotor stimulants during the seven days before the meet. Athlete s Signature

3 ADAU Banned Substances List The intent of this list is to inform athletes of substances that are NOT allows by the ADAU. Please note that this list is NOT all-inclusive and it is ultimately the athlete s responsibility to know what he or she is taking. The athlete is also responsible for his or her testosterone/epitestosterone (T/E) ratio. DO NOT use any substance before checking with your physician, National Governing Body (NGB) or the USOC Drug Reference Line at When in doubt call and ask. Anti-diarrheal: Paregoric Anti-inflammatory/Pain Relief: Darvon; Hydrocodone; Vicodin; Darvocet; Percodan; Tylox; Demerol; Percocet Diuretics: Acetozalimide; Benzhiazide; Chlorothiazide; Furosemide; and related compounds Anabolic Agents / Anabolic Steroids: Androstenedione; Androstenediol; Boldenone; Clostebol; Dehydrochloromethyltestosterone; Dehydroepiandrosterone (DHEA); Dihydrotestosterone (DHT); Dromostanolone; Epitrenbolone; Fluoxymesterone; Gestrinone; Mesterolone; Methyltestosterone; Nadrolone; Norandrostenediol; Norandrostenedione; Norethandrolone; Oxandrolone; Oxymetholome; Stanozolol; Testosterone; Tetrahydrogestrinone (THG); Trenbolone; Methanedione; Methenolone; Clenbuterol; and related compounds. Peptide Hormones and Analogues: Corticotrophin (ACTH); Human Chorionic Gonadotrophin (HCG); Luteinizing Hormone (LH); Growth Hormone (HGH, somatotrophin) Insulin-like Growth Factor (IGF ). Stimulants: Amiphenazole; Amphetamine: Bemigride; Benzphetamine; Bromantan; Chlorphentermine; Cocaine; Diethylpropion; Dimethylamphetamine; Ephedrine (ma huang); Ethylamphetamine; Fencamfamine; Meclofenoxalate; Methamphetamine; Methylenedioxymethamphetaimine (MDMA, ecstasy); Methyphenidate; Nikethamide; Pemoline; Pentetrazol; Phendimetrazine; Phenmetrazine; Phentermine; Phenylpropanolamine (ppa); Picrotoxine; Pipradol; Prolintane; Strychnine; Synephrine (citrus aurantium, bitter orange, zhi shi) and related compounds Manipulation of Urine Sample; The use of substances and methods that alter the integrity and/or validity of urine samples provided during ADAU drug testing is banned. Examples include catheterization, urine substitution and/or tampering or modfication of renal excretion by the use of diuretics, Probenecid, Bromantan, or related compounds and epitestosterone administration. I have carefully read all of the above and I fully understand and agree with all of its contents. In acknowledgement thereof, I affix my signature. Signature of Athlete ATHLETE S DRUG TESTING RELEASE FORM In consideration of the acceptance of my entry in this ADAU Powerlifting Competition, I agree to any test method deemed necessary by the ADAU and that the results of said testing method which the meet director and/or sponsors of this meet use to detect the presence of strength inducing drugs and/or controlled/banned substances may be released to any third party (ies) and I generally and specifically waive any right to privacy, if any, related thereto, to be represented by counsel, or by such other representative as I may choose, to have witnesses testify on my behalf, to be represented by counsel, or by such other representative as I may choose, to have witness testify on my behalf. My entry into this ADAU event constitutes my consent to the testing procedures; and, if any such results test positive, I understand that I shall be disqualified from the pertinent competition and suspended for a period to be fixed by the Registration Committee. I understand that I may have a hearing. I understand that I am entitled to be represented by counsel, or by such other representative as I may choose, to have witnesses testify on my behalf, and to submit and all evidence in my defense, including heresay, and documentary evidence so long as it is relevant to the issues. I understand that in that regard to a National competition, that I have the right(s) of appeal. won. If the test results are positive and indicate that I have failed the drug test, I agree to forfeit any trophy or award that I might otherwise have I hereby give my word of honor as an athlete that I have not used any strength inducing drugs (i.e., and anabolic steroid, natural hormone or synthetic growth hormone) during the past sixty (60) months, nor have I used any prescription diuretics or psychomotor stimulants during the seven (7) days before this meet. By signing this form and as a member of the ADAU, I acknowledge and agree to OUT OF MEET DRUG TESTING, 4 hours a day, 365 days a year. Failure to pass said drug testing will result in suspension from the ADAU. I ALSO AGREE THAT POWERLIFTING CAN BE DANGEROUS AND I LIFT AT MY OWN RISK, WITH NO ONE BEING RESPONSIBLE FOR ANY INJURY THAT I MAY HAVE AS A RESULT OF COMPETING IN THIS MEET. I have carefully read all of the above and I fully agree with all of its contents. In acknowledgement thereof, I affix my signature hereon: Signature of Athlete Signature of parent or legal guardian if athlete under age 8.

4 Kilogram to Pound Conversion Chart Kilogram =.046 Pounds Kilograms Pounds Kilograms Pounds _ , , Kilograms Pounds Kilograms Pounds

5 SCORE SHEET Name Body Wgt 3 3 Sub Total 3 Total