Kansas Powerlifting Reg

Location: Quality Inn, 2110 W. Crawford, Salina, KS 785-825-2111 (Map Quest for easy directions)

Meet Director: Rich Peters, P.O. Box 735, Noble, OK. 405-527-8513 sqbpdl@aol.com

Lifting will begin at 10:00 am Saturday

Rules: All Current NASA Rules will apply. See the NASA Rule Book on our Web Site at www.nasa-sports.com. NASA Membership Cards are required for this meet. Adult Cards $30.00 and Senior Lifters (65+ years old) & High School are $15.00 per year. All lifters MUST wear a Wrestling Suit or other one piece suit. All Canvas Equipment is Illegal.

Power Sports Lifters: Required to do Strict Curl, Bench Press and Deadlift In the Full Meet. Lifters may enter any event in PS individually. No Supportive Equipment is Allowed except a 4” Lifting Belt. One piece Lifting Suits MUST be worn. You may enter any event as a single lift event, i.e.-Curl, BP, Squat, DL or Full meet under any division you are qualified.

Powerlifting Lifters, Push/Pull & Bench Press Only Lifters: May use any single ply Suits, Bench Shirts, Legal Wraps for Squat, Bench Press and Deadlift. No Open Back BP Shirts allowed.

Unequipped Powerlifting & Unequipped BP: Wrist Wraps, Knee Wraps and Belt allowed. No Supportive Suits and/or BP Shirts allowed.

Bench Only Lifters: May use single ply Bench Press Shirts, Legal Wrist Wraps and Belt.

Powerlifting, Push Pull and Equipped BP: Single Ply Suits, BP Shirts and Wraps are allowed.

Unequipped Powerlifting: Wrist Wraps, Knee Wraps and Belt allowed. No Supportive Suits and/or BP Shirts allowed.

114, 123, 132, 148, 165, 181, 198, 220, 242, 275, 308 & SHW

Women’s Weight Classes

Divisions for Equipped and Unequipped Powerlifting, Push/Pull, Bench Only & Power Sports (Raw)

Police & Fire: Lifetime Anabolic Steroid Free, Full Time Police & Fire personnel.

Sub-Masters 1: 30-34 years of age, Anabolic Steroid Free for minimum 3 years.

Sub-Masters 2: 35-39 years of age, Anabolic Steroid Free for minimum 3 years.

Sub-Masters Pure: 30-39 years of age, Lifetime Anabolic Steroid free lifters only.

Masters-Pure: 40+ years of age, Lifetime Anabolic Steroid Free lifters only.

Awards: 1^st thru 5^th Place Awards for each weight class in each Division for Powerlifting and Power Sports Contests. Awards will consist of Column Trophies, Extra Large Plaques and Large Plaques.

Return Entry and Entry Fee’s

Entry Fee’s for All Powerlifting, Power Sports, Push/Pull & Bench Press Only (equipment allowed)

$55.00 for first division entered, $35.00 for each additional entry. Late Fee after Deadline Date is $5.00 additional fee for 1st division entered. Cash Only for all late entries. All On-Line High School Entries are $40.00 and Late Fee's will be charged if entries are late. No Refunds on No Shows

“Entry Fees

Full Meet - Power Sports, Powerlifting, Bench Only, Push Pull and all single lift events = $55.00

Strict Curl Only= $55.00

Bench Only=$55.00

Deadlift Only= $55.00

All On-Line High School Entries are $40.00 and Late Fee's will be charged if entries are late. No Refunds on No Shows

Team Entry Fee

$40.00 per Team Entry. This fee is for the Team Trophy. Team Rosters MUST be turned in by the start of lifting on Saturday. Trophies for 1^st thru 3^rd for Powerlifting, Bench Press Only and Power Sports Teams. Maximum of 10 members per team.

State-___ Zip-_________ E-mail:_____________________ Phone: (____)____________

Power Sports (raw) Individual Lift Divisions Only- _____, ______, ______, ______,

Total Amount Enclosed : $_____ Check #_____ Total Number of Divisions Entered:____

Card #-______ ______ ______ ______ Expires-_______ Name on Card-(print) ____________________________

I realize this Competition is an Anabolic Steroid Free Meet and I may be Tested by Urinalysis

Do Not Sign This Waiver Before Reading It Fully and Carefully. If you do not accept it’s terms, DO NOT sign it.

Athlete’s Signature:_________________________ Date:__________ No Refunds on No Shows

Parent’s Signature if Athlete is under 18 years of age:_____________________ Date:_____

No Refunds on No Shows

Step 1 - Fill Out Web Entry Form

All PayPal entry payments (Step 2) MUST be made the same day you submit your Entry Form



NASA Kansas Regional Entry Form Only

Late Fee's Begin November 15th, 2010

    First Name-    Last Name-

    Wt. Class-   Age-   DOB-     Phone-

   Address- City-

   State- Zip-        E-mail Address-

  Equipped Powerlifting Division(s) Entered (i.e. Pure, Open, M-1 etc)-,

Equipped Bench Only Division(s) Entered (i.e. Pure, Open, M-1 etc) -,

Unequipped Powerlifting Divisions Entered- , ,

Unequipped Bench Press Divisions Entered- , ,

  Power Sports Full Meet Division(s) Entered (i.e. Pure, Open, M-1 etc) - , ,

  Power Sports individual lift Division(s) Entered (i.e. Curl/Pure, DL/Open, etc) - , ,

  Push Pull Divisions Entered (i.e. Pure, Open, M-1 etc)- ,

    Grand Total Number of Divisions Entering-

    Total Entry Fee Paid to be paid-$      (Don't forget to pay by PayPal below the Submit Button or call in your Credit Card info)



You MUST submit this entry AND the PayPal Payment below to be entered in this meet. To pay by Credit Card without PayPal you must submit this entry form and then call 1-405-527-8513 to give credit card info by phone.

Comments or Questions-

Read this Waiver Completely Before Submitting - All Unsigned Entries Will Be Returned

In consideration of your acceptance of this entry, I hereby waive, for myself, my heirs and assigns, any and all claims for injury or damages which I may incur by virtue of my competing in this contest as against Rich Peters, NASA LLC Powerlifting, NASA, Quality Inn Hotel, the facility used and any and all of their agents and employees. I also realize that the sport of Powerlifting is a high risk sport and that I could be injured. I certify that I am in good physical health and have no serious health problems and that I assume full responsibility for such conditions. I realize that if I use the False Grip or Open Grip that it is a dangerous method of BP'ing and I assume full responsibility if I choose to use this method to BP. I also agree to submit to drug testing at any time during this event if I am asked to do so. I certify that I know and understand completely the NASA policy for drug testing and NASA's use of it's coefficient system and agree to their policies.I also realize that I am fully responsible for my well being and safety in the warm up room, on the lifting platform and while I am lifting at this event. I also certify, by my signature, that I have read this waiver and fully understand and accept it’s terms. I do hereby verify my acceptance by my signature below. I also realize that children and non lifters are NOT allowed in the warm-up room for any reason. I also give NASA, Rich Peters and all other parties involved in this meet permission to post my name and make my name public if I fail any Drug Test.

Do Not Agree to This Waiver Before Reading It Fully and Carefully. If you do not accept it’s terms, DO NOT sign it.

I agree to the terms of this waiver and do so indicate by my submission this Credit Card Entry.

I Realize that this Competition is an Anabolic Steroid Free Meet and I MAY be Urine Tested at any time

No Refunds on No Shows

I to the terms of this waiver (Initials)-

Security Word - nasa101

Please type Security Word, nasa101, here-

I will be paying by the following method -

(Don't forget to pay by PayPal below in Step 2 or call in your Credit Card info to 405-527-8513)

After you submit the Entry Form, please pay below - Entry is Incomplete until you pay.

Step 2 - Pay Now
All PayPal entry payments (Step 2) MUST be made within 2 hours after submitting Entry Form

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Enter All Divisions You Are Entering - Be Specific, i.e. Masters-1 Power Sports, Junior Equipped PL'ing, etc