GUYANA AMATEUR POWERLIFTING FEDERATION COMPETITION

REGISTRATION FORM Raw National 2023

All Underlined areas must be filled in, or registration will be
ATHLETE’S INFORMATION: deemed incomplete. Monies submitted will not be refunded
First Name:……………………………………………………………………. Last Name:....…………………………………………………………….………….

Address:...…………………..……………………………………………………………………………………………………………………………………….............

...............................................................................................................................................................................................

Phone #: (HOME)…………………..………………..…… (MOBILE)………………………..…………..…..

GENDER DOB
MALE FEMALE MM / DD / YEAR

Provide a Photocopy or Screen-shot of your ID or PASSPORT (if first time in 2023)

Three (3) selfies (or updated pics if you so desire) are required, submit via WhatsApp or Facebook messenger)
GYM/CLUB NAME: ……………………………………………………………………………………………………………………………………………………….

COACH’S NAME: ……………………………………………………………………………… COACH’S TEL#: ………………………………………………….

EMERGENCY CONTACT INFO:

NAME: …………………………………………………………………………. TEL #: ………………...................................

Competition Weight Class Circle only (ONE) where applicable

Female Wt-Cls 43 47 52 57 63 69 76 84 84+
Male Wt-Cls 53 59 66 74 83 93 105 120 120+

Check off Where Applicable: Select from conversion sheet

Federation dues
Division Equipped Raw/Classic Only Once Per Year $5000 Opening Attempts in kg
Gym Fees Per Athlete
Open Per Competition $1000 Squat Bench Deadlift
Competition fees
Sub Junior Per Division $2500
Penalty for weigh-In
Guyana Amateur Powerlifting Federation
Junior outside of registered $3000
Weight Class Account # 962356552194 Republic Bank

A screenshot of your filled out registration

Masters and the Bank Receipt will be accepted

Guest Lifter

Amount Received: Received by:

Article 1 Suspension (ensure to request written guidance for any questions about these rules)

The stated reasons for suspension are not a closed list and the Executive members shall collectively exercise their discretion
when opting to suspend a member of the GAPLF.
The following may be subject to Suspension:
1. Any lifter who is deemed guilty of violating the rules or disobedience toward the Federation or any official in
execution of his duties.
2. Any lifter deemed to be conducting himself in such a way as to alter his best effort.
3. Any lifter who by words or gestures threatens referees or any other official in the execution of their duties
4. Any lifter, who participates in a contest with other countries without permission of the GAPLF.

I HAVE READ AND UNDERSTOOD THIS FORM IN ITS ENTIRETY AND PROVIDED TRUTHFUL INFORMATION

Participant Name (BLOCK LETTERS) Participant Signature Date