WaGiSS Conference Registration Form

Participant Information

First and Last Name *

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Birthdate (mm/dd/yyyy) *

(mm/dd/yyyy)

Phone Number *

E-mail *

example@example.com

Confirm Email *

example@example.com

I am *

Sex *

Female Male

Age (minimum age to participate is 16 years. There is no maximum age) *

T-shirt Size (all registrants get one event shirt) *

I am interested in learning more about (select all that apply): *

Powerlifting Olympic Lifting Strongman events Other

I currently compete in (select all that apply): *

Powerlifting Olympic Lifting Strongman events I am a trainer

I am: *

Staying in the host hotel (venue) Staying offsite I live local

Please choose your schedule from the options below for each day. There are 2 classes going on at the same time so be sure to confirm you are not signing up for 2 classes at the same time frame in 2 different locations.

Some of the classes are limited in size. Classes will fill up on a first come first serve basis. Once a class is full, it will be removed from the registration page. Most classes are offered more than once to help ensure you can attend most of the classes offered through the weekend.

*Please do not sign up for two time slots of the same class. This will help ensure there is space for eveyone to attend each class.*

Friday MORNING Technique Room Itinerary (sign up for the classes you want to attend)

10:00am-12:00pm Working with Special Populations in Strength Events

Friday MORNING Classroom Itinerary (sign up for the classes you want to attend)

8:00am-9:30am Nutrition Off Season and In Competition 11:00am-12:00pm Pelvic Floor Health (Only Female attendees) 9:45am-10:45am Work through an Injury or Take Time Off?

Friday AFTERNOON Technique Room Itinerary (sign up for the classes you want to attend)

1:30pm-5:30pm Intro to Equipped Powerlifting

Friday AFTERNOON Classroom Itinerary (sign up for the classes you want to attend)

1:30pm-2:30pm Barriers to Getting Women and Girls involved in Strength Sports 2:45pm-3:45pm Competition Strategy 4:00pm-5:00pm Mobility for Power

Saturday MORNING Technique Room Itinerary (sign up for the classes you want to attend)

8:00am-10:00am Squat Technique 10:15am-12:15pm Bench Press Technique

Saturday MORNING Classroom Itinerary (sign up for the classes you want to attend)

8:00am-9:00am Mobility for Power 9:15am-10:15am Pelvic Floor Health (Male and Female attendees) 10:30am-12:00pm Off Season and In Competition Nutrition

Saturday AFTERNOON Technique Itinerary (sign up for the classes you want to attend)

1:30pm-3:30pm Deadlift Technique 3:45pm-5:45pm Squat Technique

Saturday AFTERNOON Classroom Itinerary (sign up for the classes you want to attend)

1:30pm-3:30pm Psychology for Success 3:45pm-4:45pm Starting a Collegiate or High School Club

Sunday MORNING Technique Room Itinerary (sign up for the classes you want to attend)

8:00am-10:00am Olympic Lifting Technique 10:15am-12:15am Bench Press Technique

Sunday MORNING Classroom Itinerary (sign up for the classes you want to attend)

8:00am-9:30am Barriers to Getting Women and Girls involved in Strength Sports 9:45am-10:45am Working with Special Populations 11:00am-12:00pm Pelvic Floor Health (Male and Female attendees)

Sunday AFTERNOON Technique Room Itinerary (sign up for the classes you want to attend)

1:30pm-4:15pm Strongman Technique

Sunday AFTERNOON Classroom Itinerary (sign up for the classes you want to attend)

1:30pm-3:30pm Psychology of Success

***If you have a High School or Collegiate team/club who are interested in attending this event, please contact me at dsnowpfz@gmail.com. There will be a group rate for teams/clubs of 5 or more participants.***

Emergency Information

Emergency Contact's Name *

First Name Last Name

Phone Number *

Medical Release and Authorization

As Parent and/or Guardian of the named athlete, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.

Permission is also granted to WaGiSS and its affiliates including Instructors, Coaches, and Director to provide the needed emergency treatment prior to the child’s admission to the medical facility.

Release authorized on the dates and/or duration of the registered season.

This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.

Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by WaGiSS during the selected camp. In exchange for the acceptance of said child’s candidacy by WaGiSS ., I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless WaGiSS . and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.

In case of injury to said child, I hereby waive all claims against WaGiSS including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.

Parent/Guardian Information (If participant is under 18 years of age)

Guardian's Name

First Name Last Name

Relationship

Guardian Signature

A guardian must sign this form if the participant is under the age of 18. Clear

If this event is cancelled due to COVID-19, you will recieve a full refund. If you cancel before June 6, 2021, you will recieve a full refund. No Refunds will be issued after June 6, 2021.

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Participants Signature *

Clear

Purchase your own event pull-over or ladies tank at check out.

My Products *

Full Conference (3 days)

$ 399.00

Day Pass (1 day attendance)

$ 189.00

Conference Pull Over

$ 35.00 T-Shirt

Women's Tank

$ 10.00 T-Shirt

Total

$ 0.00

2021 WaGiSS Conference Registration Aug 6-8