PA National Championship Weight Change/ Withdrawl Form

Powerlifting America Change Form

Classic Sub Junior, Junior, Masters Nationals and Equipped Nationals 2023
Name*

First NameLast Name
Email*
example@example.com
Powerlifting America Membership Number*
Are you registered as Classic or Equipped

ClassicEquipped
I want to*

Withdraw from the competition
I would like to be moved to the following weight class*
Confirm that you want to withdraw from Nationals*

I Confirm that I want to withdraw from Nationals and I understand there will be no refunds.
Signature

Clear
Should be Empty:

Powerlifting America Change Form