Nick Banu Memorial IPA State Powerlifting Championship

INTERNATIONAL POWERLIFTING ASSOCIATION Presents:

Nick Banu Memorial IPA

State Powerlifting Championship

(Full Power, Push/Pull, Bench Only, Deadlift Only)

Saturday, October 18th, 2025

Location:

Fitness 1 Gym

4316 W Bell Rd

Glendale, Arizona 85308

Schedule: Saturday, October 18, 2025

Weigh-ins:

Friday, October 17th, 9am - 12pm and 4pm - 8pm at FITNESS 1 GYM

Lifting Begins: Saturday @ 9:00am (mandatory lifters meeting at 8:00am)

Entry Fee: $100

Crossover Fee: $25 per event

T-Shirt: $30

All proceeds go to the Banu family

Eligibility:

Each competitor must have a valid INTERNATIONAL POWERLIFTING ASSOCIATION Membership. Memberships can be purchased at: https://ipapower.com/join/

Memberships will be good for 12 months (1 year). If you have previously competed in an IPA meet and are unsure of your membership expiration, please contact the meet director(s) listed below.

Uniforms:

MUST MEET International Powerlifting Association SPECIFICATIONS. ONE PIECE LIFTING SUIT MUST BE WORN. (singlet if you are competing raw)

Any questions please refer to rules https://ipapower.com/ipa-rules/ or contact meet director(s).

Weight Classes:

Women (lbs): 97, 105, 114, 123, 132, 148, 165, 181, 198, 198+

Men (lbs): 114, 123, 132, 148, 165, 181, 198, 220, 242, 275, 308, SHW

Awards:

Awards will be given for 1st place for each weight and age division, as well as Best Lifter Male and Female (overall by DOTS).

Entry Deadline: September 26, 2025

All entries must be received by September 26th, or may be accepted only if space is available – please add $35 Late Fee after SEPTEMBER 26. MAX 45 LIFTERS

Event Director:

Jeff Shellenberger

Tel. 602-703-7270

Email: preacher675@gmail.com

Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Area CodePhone Number

Email

example@example.com

Age on Oct 18th (meet day)

Date of birth

MonthDayYear

Weight class (can be changed at weigh in)

Event ($100 entry fee)

Crossover Event ($25 additional fee)

Division

Additional Division ($25 additional fee)

Attempted Opener (can be changed at weigh in)

Squat

Attempted Opener (can be changed at weigh in)

Bench

Attempted Opener (can be changed at weigh in)

Deadlift

Membership expiration date

MonthDayYear

RELEASE FROM LIABILITY In consideration of the acceptance of my entry form in this power lifting competition, I intend to be legally bound for not only myself, but also for my heirs, executors and administrators. In signing this release from liability, I waive and release any and all rights or claims for damages I may have against INTERNATIONAL POWERLIFTING ASSOCIATION, FITNESS 1 GYM, the organizers, volunteers or the sponsors of this contest. BY SIGNING BELOW, I ACKNOWLEDGE THAT I HAVE READ AND FULLY UNDERSTAND THE INFORMATION CONTAINED IN THIS DOCUMENT AND THAT I SIGN THIS RELEASE OF CLAIMS VOLUNTARILY WITH KNOWLEDGE THAT I WAIVE IMPORTANT LEGAL RIGHTS.

Release of Liability

Refund Policy

Signature of Athlete

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

My Products

Full Power (Squat, Bench, & Deadlift)$100.00

Push / Pull (Bench & Deadlift)$100.00

Deadlift Only$100.00

Bench Only$100.00

Crossover Event$25.00

Crossover Division$25.00

Meet Shirt$25.00

T-Shirt SizeQuantity
Item subtotal:

Total $0.00

**PAYMENT DUE UPON SUBMISSION

&

MUST INCLUDE LIFTERS FULL NAME**

Submit payment by

Venmo: @Jeff-Shellenberger-1
or
Zelle: 602-703-7270