2025 Single Event Nationals Meet Registration

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

Age on 4/5/2025*

Date of Birth*

Date

Age Division*

Sex*

FemaleMale

Weight Class*

Events*

Meet T-shirt *

The first shirt is included with your registration

Additional Meet T-shirts ($20 each)

Please indicate what size(s) you want to order and the quantity

If you are currently employed full-time as a POLICE Officer, FIRE-Fighter or as MILITARY Personnel

Check here

List medications that you have taken in the last 2 weeks*

Official Release Form Certification:

I hereby give my word of honor that I am LIFETIME drug free, I have not used anabolic steroids or other anabolic agents that would be considered banned substances by the WORLD ANTI-DOPING AGENCY & the International Olympic Committee. I further agree NOT to use prescription diuretics in an effort to make weight NOR will I take psychomotor stimulants for this competition.

Signature*

Signature of parent/guardian if athlete is under 18 years of age

Release From Liability

Please read this release very carefully, as when you sign it, you will be giving up important legal rights!

In consideration of the acceptance of my entry form for 2025 ADFPF INDIANA/Kentucky State, I intend to be legally bound for not only myself but also my heirs, my executors and my administrators. In signing this release from liability, I waive and release anyone connected with this competition, i.e. The Pit Barbell Club, the Meet Directors, the officials, the spotters and loaders, the A.D.F.P.F. and W.D.F.P.F. or any persons associated with the competition from any and all liability which may arise from this competition.

Additionally, I understand that Powerlifting is an inherently hazardous activity and that participation in this sport exposes me to the risk of injury or death. I further understand that the A.D.F.P.F. will NOT reimburse me for, nor provide coverage of any medical expenses incurred by me as a result of injuries that I might sustain, training for, traveling to or from, or participating in the competition acting as bench press lift-off personnel.

Moreover, I agree that the results of any testing method selected by ADFPF recognized testing officers for the purpose of detecting the presence of drugs, as listed on the International Olympic Committee (I.O.C.) and World Anti Doping Agency (WADA) banned substances lists, SHALL BE CONCLUSIVE. I agree to cooperate fully with all required I.O.C. & WADA sampling and testing procedures. This includes any testing procedures that may be considered necessary prior to or after this event. Should I fail to pass the drug testing procedures, I agree to forfeit any trophy, award, record or placing that I might otherwise have won. I also agree to waive any claim that might arise under state, national or international law for defamation, slander, libel or any other claim for which legal relief is available.

I agree to pay any attorney fees and litigation expenses incurred by any person, real or corporate, which I may sue in effort to challenge this release from liability. I understand that my agreement to pay attorney fees and litigation expenses is the SINE QUA NON for acceptance of my entry in this contest. If any provision of this Release From Liability shall be deemed by a court of competent jurisdiction to be invalid, the reminder of this Release From Liability shall remain in full force and effect. I also certify with my signature that this release/agreement cannot be modified orally.

Signature*

Signature of parent/guardian if athlete is under 18 years of age