Please type or print clearly, and mail the Strict Curl Contest registration form before the Monday, October 27, 2008, deadline to Pinnacle Performance, P.O. Box 143, Charenton, LA 70523.

Name
Address
Phone
Email
Age	(you must be 18+ years of age to enter)
T-Shirt Size

Circle weight class.

Female To be announced

Male Lightweight (181 and below), Middleweight (181-220) Heavyweight (over 220)

Estimate your opening attempt, Curl _______ pounds

Circle category. Men’s Open (nontested), Men’s Open (drug tested), Women’s Open (nontested), Women’s Open (drug tested)

Circle affiliation. APA Member ($30/year; records will be recorded when you are a member), APA Nonmember (no added cost, but your record will not be noted)

Please check one.

o I have enclosed a nonrefundable registration fee in the amount of $35, made payable to Pinnacle Performance, and remitted to P.O. Box 143, Charenton, LA 70523.

o A nonrefundable registration fee in the amount of $35 has been made via PayPal.

In consideration of the acceptance of this entry thereby for myself, my heirs, executors, and administrators waive and release any and all claims and damages I may have against the American Powerlifting Association, Pinnacle Performance Physique and Strength Sport Enterprises, Inc., Baja Sports Grill, their representatives, successors, and assigns for any and all injuries or bodily harm that I may suffer while competing at the 2008 Strict Curl Contest. I attest and verify that I am at least 18 years of age, and I have full knowledge of the risks involved with my participation of this event. I understand, upon entering a drug tested division, there is random drug testing by urinalysis on a minimum of 10% of lifters. APA policy bans a lifter for a period of 3 years if he or she tests positive for a banned substance. Being unaware that a substance can cause a drug test failure is not an excuse.

Signature _________________________ Date _______________