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Family First Athletic Club First Annual Bench Press Competition

Registration Form

Name: ____________________________________ College Student____ Faculty/Staff____ Community____ Commuter____ Local Address: _____________________________ Email: ____________________________________ Phone: ____________________________________ Age: ______________________________________ Division: Mens Open

Mens Raw

Mens Raw & Open

Womens Open___

Total Cost: _________________________________ Requested T-Shirt Size: _________


(Please make checks payable to____ ) Early Registration and payment must be turned into Family First Athletic Club no later than 12pm on Friday, (enter date). Walk-Up Registration is available at _________ early on the day-of the competition, (enter date). Assumption of Risk, Release, and Healthcare Verification I, the aforementioned participant, agree to indemnify, defend, and hold harmless, Family First Athletic Club and their officials, agents, sponsors, and employees from any claims, damages, and actions of any kind of nature, whether at law or in equity, arising from my participation in Family First Athletic Clubs First Annual Bench Press Competition on (enter date) I realize that my participation in this activity involves risks of injury including but not limited to tendonitis, strains, sprains, bursitis, fractures, delayed muscle soreness, contusions, abrasions, and even the possibility of death. Also, I recognize that there are many other risks of injury including serious and disabling injuries that may arise due to my participation in this activity and that it is not possible to specifically list each and every individual injury risk. By signing this form I desire, consent, and voluntarily choose to take part in this activity. Knowing the risk and reasonably anticipating that other injuries and death are a possibility assume all the risks accompanying the nature of the activities and agree that the Family First Athletic Club or any of its officers, agents, sponsors, and employees conducting such activities will not be responsible for any damages or injuries to me. Furthermore, I also confirm that I have appropriate healthcare insurance for this activity, or if not, I will not rely upon the Family First Athletic Club for medical expenses. Also, I understand that any injury incurred and the resulting medial expense from injury will be my responsibility and the Family First Athletic Club will not be responsible for any related expenses. I hereby grant any approved video or entertainment organization and all of their agents, successors, licensees and assigns, the right to photograph or otherwise reproduce my voice, appearance and name, and to exhibit, distribute, and/or transmit all media, by means of still photography, motion pictures, radio, television, television motion

pictures, video, or printing, including with respect also to any advertising and/or publicity, and the right to use my name and information about me in any connection with any of the foregoing and no further compensation shall be payable to me at anytime in connection therewith. I hereby affirm that I have read, fully understand, and agree to accept the terms, policies, and conditions of the above document in its entirety.
____________________________ __________ ________________________________ _______

Participants Signature Date Guardians Signature Date


Mail completed form and payment to:

(Enter address)
(Enter date/time)
Early weigh-in (date/time) Event Day Weigh-in (date/time) SHARP (Weigh-in will be held in enter location) Rules briefing all competitors at 9:45am, Competition begins at 10am

Entry Fees:
*Early Online Registration Deadline (date/time) Email/web address $15 College Student $20 Family First Faculty/Staff $25 All Other Participants *Walk-Up Registration (Location) $20 College Student $25 Family First Faculty/Staff $30 All Other Participants * Add $10 to compete in a second division

Divisions & Weight Classes:


Mens Open 148 - below 148 - 165 lbs 165 - 181 lbs 181 - 198 lbs 198 - 220 lbs 220 lbs above `Mens Raw Division 165 - below 165 - 198 lbs 198 - above Ladies Open Light: 122 below

Middle weight: 122 -140 Heavy weight: 140 lbs above `

Awards: 1st 3rd in each class, Best overall male/female All contestants will receive a T-shirt Basic Rules: Shoulders and buttocks on bench. No bouncing or sinking of bar. Touch and go. Wrist wraps allowed. No elbow wraps. No lifting shirt allowed No baggy clothing. **IMPORTANT** Lifters competing in the Raw and Open get three attempts total. Most lifters will open with a Raw lift and then use the next two lifts for open lift. If the second two lifts fail, the Raw lift will count for both divisions. For more information see (web Address) or call 814-866-2429