RANCHO BUENA VISTA HIGH SCHOOL CLEAN AND JERK CHAMPIONSHIPS.


WHEN:  SATURDAY, MAY 4TH, 2002

RETURN ENTRY TO:MIKE BURGENER, STRENGTH COACH, RANCHO BUENA VISTA HIGH SCHOOL,1601 LONGHORN DRIVE, VISTA, CA. 92003

ENTRY DEADLINE: Tuesday, APRIL 30, 2002

ENTRY FEES:$10.00 INDIVIDUAL.THERE IS NO TEAM ENTRY.

WEIGH IN:ALL ATHLETES: 0800 WEIGH IN:LIFT AT 1000 HRS

WT CLASSES:MEN:56 KG, 62 KG, 69 KG, 77 KG, 85 KG, 94 KG, 105 KG, 105+ 

ALL LADIES AND JR HIGH STUDENTS WILL BE AWARDED BASED ON THE SINCLAIR FORMULA MODIFIED:WEIGHT LIFTERD DIVIDED BY BODY WT.

AWARDS:1ST, 2ND, 3RD PLACE FINISHES IN EACH CLASS OF MEN

                1ST –10TH PLACE FINISHES IN WOMEN AND JR HIGH.

                TEAM PLACE:1ST AND 2ND PLACE.

PLEASE ENTER ME IN THE 2001 HIGH SCHOOL CLEAN AND JERK . WT. LIFTING CHAMPSIONSHIPS TO BE HELD ON

____________SATURDAY, MAY 4, 2002____________________.I CERTIFY THAT I AM AN AMATEUR IN GOOD STANDING.IN

CONSIDERATION OF MY ENTRY IN THE COMPETITION, I DO HEREBY WAIVE, AND RELEASE THE RANCHO BUENA VISTA HIGH SCHOOL

SOUTHERN PACIFIC LWC , AND TEAM SOUTHERN CALIF. ITS DIRECTORS, OFFICERS, OFFICIALS, AGENTS AND

COMPETITION PERSONNEL, HEREINAFTER KNOWN AS THE ORGANIZERS, FROM ANY AND ALL CAUSES OF ACTION, LOSS,

LIABILITY, CLAIMS AND DEMANDS OF EVERY KIND AND NATURE,WHICH I OR MY HEIRS OR PERSONAL

REPRESENTATIVES MAY HAVE FOR BODILY INJURY, INCLUDING PARALYSIS, DISMEMBERMENT AND DEATH, AS WELL AS

LOSS OF OR DAMAGE TO PROPERTY AND FOR EXPENSES OF MEDICAL TREATMENT, HOSPITALIZATION AND OTHER CARE

RENDERED TO ME IN THE EVENT OF MY INJURY OR ILLNESS, OR FOR ANY AND ALL OTHER COSTS, DAMAGES OR LOSSES

SUFFERED OR INCURRED BY ME OR OCCASIONED TO ME IN CONNECTION WITH MY TRAVEL TO AND FROMAND MY

PARTICIPATION IN, THE COMPETITION AND RELATED ACTIVITIES.

I HEREBY RELEASE AND AGREE TO HOLD THE ORGANIZERS, ITS AGENTS AND COMPETITION

PERSONNEL HARMLESS FROM ALL EXPENSES, CAUSES OF ACTION, LIABILITY, CLAIMS AND

DEMANDS ARISING FROM GOOD FAITH JUDGMENTS MADE BY THE ORGANIZERS, ITS AGENTS AND

COMPETITION PERSONNEL CONCERNING MY TREATMENT, HOSPITALIZATION AND MEDICAL CARE IN

THE EVENT OF MY ILLNESS, INJURY OR OTHER EMERGENT CIRCUMSTANCES IN CONNECTION WITH

THE COMPETITION.

I AND MY PARENT (IF I AM A MINOR) AGREE THAT I WILL BE FINANCIALLY RESPONSIBLE FOR

TREATMENT, HOSPITALIZATION AND OTHER MEDICAL TREATMENT RENDERED TO ME IN THE EVENT

OF MY ILLNESS OR INJURY.

WAIVER SIGNED BY PARENT (IF UNDER 18) _______________________________

NOTE:ALL TEAM SOUTHERN CALIF. MEETS ARE OFFICIALLY SANCTIONED BY USA WT. LIFTING.

OFFICIAL ENTRY

PLEASE PRINT ALL INFORMATION CLEARLY

WEIGHT CLASS:_________________

NAME:________________________________________________

ADDRESS:_________________________________________

CITY:_____________________________STATE:____________ZIP____________________

PHONE:___________________ AGE:________________ DATE OF BIRTH_______________

CLUB AFFILIATION:_________________________________________

COACH:___________________________________

MALE______________ FEMALE_______________

TITLES HELD:______________________________________________________

SIGNATURE________________________________DATE:________________

UNDER AGE (UNDER 18) ATHLETES MUST HAVE PARENTS SIGNATURE.

I HAVE EXPLAINED TO MY SON/DAUGHTER THE AFOREMENTIONED RELEASES AND CONDITIONS AND THEIR

RAMIFICATIONS AND I FURTHER CONSENT TO HIS/HER REGISTRATION FOR THIS USA-WT.LIFTING ACTIVITY UNDER THE

ABOVE -STIPULATED CONDITIONS.

SIGNATURE_______________________DATE:__________________

PRINTED NAME:_________________________________(PARENT OR GUARDIAN)