Powerlifting Face-Off Challenge
Entry Registration Form

Qualifying event for the World Powerlifting Games!
Host: Q Athletic Performance Center, 140 Raceway Drive, Mooresville, NC 28117
When: Saturday March 9, 2019  
Federation Chairmen: Bill Clary  
Sanction by: 365 STRONG World Powerlifting Federation 
Classifications: Drug “Tested” or “Untested” (“Open Divisions” only)
Divisions:  All athletes compete against like competition!
>Open  >Novice (Competed previously Class II or below)  >Masters  >Teenage  >M/P/F  >Special Olympians  >New Division: Cross-Over for Cross-Fit, Strongman, Kettlebell, Middle School, High School, College, Adult, Masters, etc. Athletes (never previously competed in powerlifting)  
Competition: >Full Power  >Push Pull   >Squat Only   >Bench Only   >Deadlift Only
Single/Combo Lifts – Bench Press Only, Deadlift Only; Push-Pull (Combined Total of Bench and Deadlift) 
Weigh-in Location: Q Athletic Performance Center
Early Weigh–Ins: Friday March 8, 2019: 10:30am – 12:30pm and 4:00pm – 6:00pm  
Late Weigh-Ins (advanced approval necessary): March 9th from 7:00-8:00am 
Eligibility: Open to all lifting competitors. Lifters may become a Lifetime 365 SPF member card holder (at 365strong.org) online for only $45, pay $30 for annual membership.
Standard Full Power Entry Fee: $100 for one division and $50 for each additional Crossover division entered.  Bench, Deadlift & Push-Pull Only Entry Fee: $85
All Military, Law Enforcement, Fire Fighters, Teens and Special Olympians Full Power Entry Fee: $85 for one division and $50 Crossover Fee per additional Division 
Deadline/Late Entries: All Entries MUST be received by March 2, 2019 or be charged a Late Entry Fee of $50. LIMITED TO 50 LIFTERS! REGISTER EARLY!! 
Uniform: Mandatory - Must have one piece lifting suit or wrestling singlet. 365 SPF rules apply @ 365strong.org.
Agenda: Mandatory rules briefing is Saturday @ 8:00am; Lifting begins at approximately 9:00am
Awards: 1st thru 3rd place in weight class Divisions, 1st thru 4th if the division is divided by Light, Middle and Heavy weight categoroies.  Best Lifter awards.
Methods of Payment: Mail Check to: “365 SPF” Online: 365strong.org (PayPal online)
Return Address: 365 SPF, PO Box 253, Fort Mill, SC 29716
Contact Numbers: Bill Clary: 704/236-1899 
Website / Email: Website: 365strong.org Email: info@365strong.org


RELEASE OF LIABILITY WAIVER (READ BEFORE SIGNING and return with entry form with entry fee)

In consideration of being allowed to participate in any way in the 2019 Powerlifting Faceoff Challenge, Sanctioned by the 365 SWPF, its related events and activities, I The undersigned, acknowledge, appreciate, and agree that: 1. The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular skills, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and, 2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and, 3. I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the 365 SWPF officials immediately; and, 4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS THE Meet Director/Promoter Bill Clary, 365 Strong World Powerlifting Federation, Q Athletic Performance Center, center personnel, 365 SWPF officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used for the activity ("Releases"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

FOR PARENTS/GUARDIANS OF PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT TIME OF REGISTRATION) This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releases, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releases from any and all liabilities incident to my minor child's involvement or participation in these programs as provided above, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law.