(2022-MS-01) Powerlifting America Brother Bennett Memorial

Powerlifting America

Mississippi Open

(2023-MS-01)

Anatomies

120 98th Place Blvd, Hattiesburg, MS 39402

September 30, 2023

Eligibility:

NO qualifying total is required. Open to the first 60 athletes

All Athletes are required to be current members of Powerlifting America two weeks before the event.

Membership cards can be purchased here: Membership

Uniforms:

All support suits, shirts, wraps, and singlets must be on the IPF spec.

Awards:

Medals will be given to 1st - 3rd place by total and weight class for all divisions.

Note:

All registered lifters are subject to drug testing before or after the competition from USADA or CCES!

Admission for spectators and personal coaches: $10.00 at the door.

Deadline to Enter: November 26th

Tentative Schedule of Events: (Subject to Change)

Saturday, September 30

Session 1

7:30 - 9:00 AM Weigh-ins for all Athletes

9:30 AM Lifting Begins for all Athletes

Event Director:

Jeff Douglas

Tel. 601.818.3201

Email: JDMD1987@gmail.com

Full Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number*

Area CodePhone Number

E-mail*

Date of Birth*

MonthDayYear

Powerlifting America Membership#

Select Your Weight Class*

Equipment*

Team

Division(s) Entering*

Event(s) Entering*

Powerlifting (Squat, Bench, Deadlift)Push-Pull (Bench, Deadlift)Bench OnlyDeadlift Only

Entry Code

Official Championship Apparel

Small T-Shirt

$20 each

Medium T-Shirt

$20 each

Large T-Shirt

$20 each

XL T-Shirt

$20 each

2XL T-Shirt

$20 each

3XL T-Shirt

$20 each

4XL T-Shirt

$20 each

Total

USDDivision + T-Shirts

Refund Policy*

I understand all sales are final and there will be no refunds for any reason.

Signature of Athlete*

Signature of Parent or Legal Guardian for Athletes under the age of 18

Base Price

Only used if multi division/event is being used (Base price + Event Calculation + Division Calculation +T-Shirt $ - Discount)

Event Calculation

Only used if multi division/event is being used

Division Calculation

Discount

Calculated Total

T-Shirt(S-L)

Price for

T-Shirt(XL-2X)

Price for

T-Shirt(3X-4X)

Price for

T-Shirt S

T-Shirt M

T-Shirt L

T-Shirt XL

T-Shirt 2XL

T-Shirt 3XL

T-Shirt 4XL

T-Shirt $ Total