NAME____________________________________AGE________________ In the space provided, list what you would like the announcer to say:

STREET ADDRESS_____________________________________________ __________________________________________________________

CITY/STATE/ZIP CODE_________________________________________ __________________________________________________________

PHONE NUMBER_______________________________________________ __________________________________________________________

E-MAIL________________________________________________________ __________________________________________________________

TEAM_________________________________________________________ TRAINER_________________________________________________
In consideration of accepting this entry, I hereby, intending to be legally bound for myself, my heirs, executors and administrators,(i) Waive any and all rights and claims for damages I may have against Missouri State
Championships, Chad Nicholls, Kim Chizevsky-Nicholls, The National Physique Committee of the U.S.A., Inc. (NPC), the Springfield Expo Center, or the agents, employees, representatives or assigns of any of the foregoing persons or
entities for any and all injuries or damages I may incur while traveling to and from, or participating in, this competition (ii) I certify that I am an amateur in good standing and am eligible to compete in this competition in the division(s) in
which I have entered, and (iii) I further agree to abide by all decisions of the NPC and declare that all information contained herein is, to the best of my knowledge, true, correct and complete.

Competitors Signature_____________________________ Parent/Guardian Signature (If under 18 years of age) _____________________________

NPC CARD#______________________________________ COMPETING IN: Check Division(s) entered please note
Submit $75.00 for EACH Division entered
ENTRY FEE: $75.00 For EACH Class entered NO REFUNDS ______Teen Men BB ______Novice Figure _______Wheelchair
______Mens Novice BB ______ Open Figure _______Novice Womens Physique
Cut along line below and mail with check, cash or money order to: ______Mens Open BB ______Masters Figure _______Open Women Physique
______Masters Men BB ______ Novice Bikini _______Masters Womens Physique
Chad Nicholls, P.O. Box 9101, Springfield, MO 65801 ______Womens Novice BB ______Open Bikini _______Novice Mens Physique
(Make Checks Payable to Chad Nicholls) ______Womens Open BB ______Masters Bikini _______Open Mens Physique
______Masters Women BB ______Womens Fitness _______Master Mens Physique

YOU MUST LIST YOUR WEIGHT AND/OR HEIGHT CLASS BELOW:
*Entries must be postmarked by JULY 1, 2014 to avoid $75.00 late fee. __________________________________________________________
ALL ENTRY CONFIRMATIONS WILL BE SENT VIA EMAIL




Weigh/Check-Ins: MANDATORY CHECK-IN/WEIGH-IN FOR ALL COMPETITORS IN ALL CLASSES - MANDATORY
Friday, July 11, 2014 Springfield Expo Center; 635 E. St. Louis Street, Spfd, MO 65806 - FROM 4:00p.m. 6:00p.m.

Date & Times: SATURDAY, JULY 12, 2014 Athlete Meeting 8:30 a.m. - Pre-judging 10:00 a.m. - Meeting 5:30 p.m. - Finals 6:00 p.m.

Place: Springfield Expo Center; 635 E. St. Louis Street, Springfield, MO 65806
Promoters: Chad Nicholls & Kim Chizevsky; P. O. Box 9101, Springfield, MO 65801; e-mail: MayhemMailBag@aol.com

Divisions: Men: Bantam Wt. 143 and under, Light Wt. over 143 and up to and including 154 , Middle Wt. Over 154 and up to and including
176 , Light Heavy Wt. - over 176 and up to & including 198 , Heavy Wt. - over 198 and up to & including 225, Super Heavy Wt. -over 225
Women: Light Wt. 114 and under, Middle Wt. over 114 and up to & including 125 , Heavy Wt. - Over 125
Masters Men: 4 Classes 35 39 years old, 40 49 years old , 50 - 59 years old and 60 & older; Masters Women: 1 class 35 & Over
Novice Men Light Wt. Up to and including 154 , Middle Wt. Over 154 and up to & including 176 , Light Heavy Wt. Over 176 and
up to & including 198 , Heavy Wt. Over 198 Novice Women One Class - Teen Men One Class - Fitness Competitors One Class Novice
Figure One Class Open Figure Two classes A & B, Masters Figure Competitors One Class 35 years old and over - Novice Bikini One
Class Open Bikini - Two Classes A & B - Masters Bikini Competitors - One Class 35 years old and over - Wheelchair Division Mens and
Womens classes Novice Mens Physique One Class Open Mens Physique One Class - Masters Mens Physique - One Class 35 years old and
over Novice Womens Physique One Class -Open Womens Physique One Class - Masters Womens Physique - One Class 35 years old and over

Eligibility: THIS EVENT IS OPEN TO ALL REGISTERED NPC ATHLETES: (1) Each competitor must be a current member with the NPC - To meet this
requirement, he/she must present his/her current NPC card, current NPC Receipt, or purchase your NPC card at this event ($120). (2) Each competitor must
be an amateur in good standing with the NPC. MASTERS (Men & Women): Each competitor in these Divisions also (1) by July 12, 2014 must have
reached the age for the respective Masters class in which he/she has chosen to compete (2) and must provide proof of age with a birth certificate, drivers
license, state i.d. FIGURE & BIKINI: One (1) round two-piece swimsuit. FITNESS: Two (2) rounds two-piece swimsuit & routine round. TEEN
CLASS: Each competitor in this Division must (1) have reached his 13
th
birthday, but not his 20
th
birthday, by July 12, 2014, and (2) must provide proof
of age with a birth certificate, drivers license or state i.d. MENS PHYSIQUE: One (1) round Surf style board shorts. No shirt, sneakers or sandals are
to be worn on stage. WOMENS PHYSIQUE: Two (2) rounds Physique Assessment & Individual Routine Round.

Awards: Beautiful Awards will be presented to places 1 5 in all classes. Awards will be presented to the Overall Champions. This is a National Qualifying event
for ALL Open Divisions. Qualification for National Level Competition is good for one (1) year.

Rules: ABSOLUTELY NO DREAM TAN IS TO BE USED!!! Light Oil is allowed. Athletes who compete in the pre-judging must compete in the evening show.
Bodybuilders are to wear suits of a single color to prejudging; Womens Physique, fitness, figure & bikini may wear multi-colored suits that may be
embellished and may wear tasteful jewelry. Mens physique is to wear board style shorts. Athletes must exhibit good sportsmanship at all times. Only
competitors and officials are allowed backstage and in the pump-up room. NO EXCEPTIONS NO KIDDING! CURRENT NPC RULES APPLY.

Posing/ Music: All athletes will be presented or perform posing routines to music in the Evening Finals. All posing routines will be limited to 60 seconds in length.
COMPETITORS IN CATEGORIES THAT REQUIRE A POSING ROUTINE: Please email your music to our sound tech Bryan at:
bryan_mycoff@yahoo.com . Acceptable formats for emailing your routine music are: .wma; .mp3; .asf & .wmv. CD files ending in .cda are NOT
acceptable as they DO NOT contain audio files. Even if you email your music, please bring 2 backup CDs with you to the check-ins. CDs must be cued
to the beginning of the CD CDs containing multiple songs will NOT be accepted. NO PROFANITY IS ALLOWED IN MUSIC - PERIOD!

Hotel: Discounted lodging is available through the University Plaza Hotel 417-864-7333 (Please mention the Missouri State Championships to obtain a discounted
rate) All reservations must be made no later than JULY 1, 2014 TO SECURE YOUR ROOM.