2021 USA Powerlifting Liberty Bell Classic (PA-2021-02)

2021 USA Powerlifting Mighty Mick's Classic

USA Powerlifting Sanction PA-2021-12 | August 21, 2021
DAN CAMPOS FITNESS
4926 Pearson Ave
Philadelphia, PA 19114

Meet Directors : Michele Warhurst, Dan Campos

Questions : michele.s.warhurst@gmail.com

Any MX or Para lifters, please email Michele while we work to update the registration form.
Athlete Information

As it appears on your USA Powerlifting membership card
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State

Zip Code
Phone Number *
Cell
E-mail *
An email address that we can contact you in case of any unforeseen changes.
Birth Date *

Month Day Year
Male or Female *

Male Female
Membership Information
USAPL Number *
Must be a current member of USA Powerlifting to register for this competition, with an expiration date of Dec. and the current year.
Expiration Date *

Month Day Year
State registered *

Street Address

Street Address Line 2

State
To look up your membership number click the link below:

Look up my Membership
All lifters competing in a USA Powerlifting competition must be a member of USA Powerlifting. If you are not currently a member or need to renew your membership go to the link below and select your appropriate option.

Membership Section
Parent/Guardian Information

If under the age of 18
Name

First Name Last Name
Address

Street Address

Street Address Line 2

City State

Zip Code
Phone Number
Cell
E-mail
example@example.com
Emergency Contact Information
Name *

First Name Last Name
Phone Number *
Cell
E-mail
example@example.com
Age Divisions

The additional division will add $35 to your total price
First Division *
Please make sure you have chosen RAW or EQUIPPED correctly
Additional Division
Please make sure you have chosen RAW or EQUIPPED correctly
*There are no refunds for any reason. Upon receipt of your registration fee, your transaction is deemed final.* *

I have read and recognize there will be no refunds for any reason
Body-Weight Divisions
Choose your Weight Class in Kilograms *
Weight in lbs x 2.2046 = Weight in kg
Event Selection

Full Powerlifting, Push-Pull, Bench Only, Deadlift Only = $85 | Additional Age Division = $35
Full Powerlifting is all three lifts : Squat, Bench press, Deadlift.

Push-Pull is bench press and deadlift only.

*NOTE*
If you enter into "Full Powerlifting" and break a single lift record, you are eligible for that record. You do Not have to enter into the single lift events to acquire those records. If you wish to receive an award for multiple events you will need to register for each event.
Raw (unequipped) or Equipped *

Raw Equipped
Event Selection *

Full Powerlifting $85 Push-Pull $85 Bench Only $85 Deadlift Only $85
*There are no refunds for any reason. Upon receipt of your registration fee, your transaction is deemed final.* *

I have read and recognize there will be no refunds for any reason
Pre-Order Your T-Shirt
Meet T-Shirt *
Shirt Size
Subtotal:
Including Shirt:
Registration Total: *
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USD 2021 USA Powerlifting Mighty Mick's Classic (PA-2021-12)
Awards will be presented for each age division and event(s) entered.
*There are no refunds for any reason. Upon receipt of your registration fee, your transaction is deemed final.* *

I have read and recognize there will be no refunds for any reason
Should be Empty:

2021 USA Powerlifting Mighty Mick's Classic

Athlete Information

Membership Information

Parent/Guardian Information

Emergency Contact Information

Age Divisions

Body-Weight Divisions

Event Selection

Pre-Order Your T-Shirt