Kentucky State & Midwest Regional
Registration Form
Where:
Cave City Convention Center, 502 Mammoth Cave Street, Cave City, Kentucky
When:
Saturday March 18, 2023
Meet Hosts:
Cave City Fitness
365 SWPF Chairman & Meet Director:
Bill Clary
Sanction by:
365 Strong World Powerlifting Federation (365 SWPF)
*Separate Events: >KENTUCKY STATE MEET >MIDWEST CHALLENGE
Men & Women Division Category:
>"Tested"
(subject to drug test)
or >"Untested"
(no drug test given)
Featured Competition:
FULL POWER, PUSH PULL, SQUAT ONLY, BENCH ONLY, DEADLIFT ONLY & STRICT CURL ONLY
Early Weigh–Ins:
Friday, March 17, 2023: 10:00am – 12:00pm
and
4:00pm – 6:00pm
Late Weigh-ins:
Saturday, March 18, 2023: 7:00am-8:00am (by request only)
Eligibility:
Open to all lifting competitors 10 years of age and older. 18 and under lifters must have parental approval.
Membership:
(at 365strong.org) Apply online for your VIP Lifetime or Annual Membership.
Event Criteria:
The Kentucky State meet is only open to all Kentucky residence, the Midwest Challenge is open to any athlete living in or out of Kentucky. Kentucky State entries may crossover to enter both.
Standard Full Power Entry Fee:
$
105
for one division
Full Power Military, Law Enforcement, Fire Fighters, Teens, Special Olympians and Push Pull, SQT, BP and DL Only Entry Fee:
$
90
for one division
Crossover and/or Standing Curl Fee: The "Crossover" and/or Standing Curl fee:
$
50
Deadline/Late Entries:
All Entries MUST be received by
March 8, 2023
or be charged a Late Entry Fee of $50. NO ENTRIES accepted the WEEK OF the MEET
Uniform:
Mandatory - Must have one piece lifting suit or wrestling singlet. 365 SWPF rules apply @ 365strong.org.
Mandatory rules briefing:
Saturday @ 8:00am; Lifting Begins at approximately 9am (upon completion of warmups and Opening Ceremonies)
Awards:
1-3rd place all Division Weight Classes, formulas are used for naming the Best Male & Female Lifters
Meet Flight Splits:
Will be announced to all competitors the week of the event
Online Registration:
Go to
www.365strong.org
website "Upcoming Events" page and follow instructions to pay via PayPal; or Mail Check Made Out to: “365 STRONG”, PO Box 253, Fort Mill, SC 29716
Contact Numbers:
Bill Clary: 704.236.1899, Email:
info@365strong.org
Website:
www.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
2023 Kentucky State
and
Midwest Challenge
, Sanctioned by 365 Strong World Powerlifting Federation, 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 SPF 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 host Nathan Crawford, 365 SWPF Chairman Bill Clary, 365 STRONG Powerlifting Federation LLC, Cave City Fitness, Cave City, KY, Cave City Convention Center, any property representatives, all 365 SWPF officers, meet referees, all event personnel, 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.
Name
Address:
City, State, Zip:
Email
Phone
Other Phone
Date of Birth:
Home (Team) Gym:
Competitive Highlight:
Records:
Meet Personal Bests:
Post your meet PR's for full power or single or combo lift events.
Membership Status:
Enter Yes (you applied today) or No (you will apply at later date)
Meet Selection:
Choose one or more options
Kentucky State Championship
Midwest Challenge
Division Category:
Tested
Untested
Lifting Preference:
You may change your preference at weigh-ins.
Raw (knee sleeves permitted)
Raw Classic (knee wraps permitted)
Equipped Single-Ply
Unlimited Geared Multi-Ply
Competition Categories Entering:
Making more than one selections (except the curl) constitutes paying a crossover fee.
Full Power
Push Pull (BP & DL only)
Squat Only
Bench Press Only
Deadlift Only
Strict Curl Only
Division Categories Entering:
Open
Juniors (20-23)
Submasters (35-39)
Novice
Teen (13-19)
Youth (10-12)
Masters (40+)
M/P/F
Para-Lifter/Special Olympians
Kids Club
Men's Weight Class Entering:
114.5lb/52kg
123.5lb/56kg
132.25lb/60kg
148.75lb/67.5kg
165.25lb/75kg
181.75lb/82.5kg
198.25lb/90kg
220.25lb/100kg
242.5lb/110kg
275.5lb/125kg
308.75lb/140kg
308.8+lb/140.1+kg
Women's Weight Class Entering:
97.0 lb/44kg
105.75lb/48kg
114.5lb/52kg
123.5lb/56kg
132.25lb/60kg
148.75lb/67.5kg
165.25lb/75kg
181.75lb/82.5kg
198.25lb/90kg
220.25lb/100kg
242.5lb/110kg
242.6+lb/110.1+kg
I agree to abide by all terms of the Entry Information and the Waiver General Release:
YES
NO
Meet T-Shirt Size:
Adult S
Adult M
Adult L
Adult XL
Adult XXL
Adult XXXL
Kids Sizes (note in comments)
Walk-up Lifting Song
Please provide the name of your song and artist.
Comments
Lifter Name Confirmation
Parent or Guardian Approval (if under 18 years old)
Register