Grand Canyon State Winter Games
2012 Grand Canyon State Winter Games
Weightlifting Competition
Dates: Saturday January 28th, 2011
Events:
Division I – Olympic-Style Weightlifting
Division II – RAW Push Pull (Bench Press, & Dead Lift) No equipment Raw (Limited to the first 30 competitors)
LOCATION:
Performance One Advanced Sports Training Inc
916 E. Baseline Rd Suite 130
Mesa, AZ 85204
480-813-5477
ENTRY FEES: Made Payable to Performance One
Division I – Weightlifting (Snatch and Clean & Jerk)
Pre Registration $30
Day of Event $40
Division II – Push Pull (Bench, & Dead Lift)
Pre Registration $50
Day of Event $60
Pre Registration $40 Single Event
Day of Event Single $50
ENTRY DEADLINE: Postmarked on or before Jan 21st, 2012. Entries not taken on the Grand Canyon State Games Entry form, website, or at the State Games online entry site.
TENTATIVE SCHEDULE OF COMPETITION
SESSION 1 Olympic Weightlifting
Women Weight Classes 48, 53, 58, 63, 69, 75, 75+ Kilos
Weigh In 7-8 Am Lift 9 AM –
SESSION 2
Men’s Weight Classes 56, 62, 69, 77, 85, 94, 105, 105+ -Kilo
Weigh In 9-10:00 AM Lift 11:00 AM
SESSION 3: Push Pull
All Men’s Weight Classes 56, 62, 69, 77, 85, 94, 105, 105+ -Kilo MEN
WEIGH IN 12-1 PM LIFT 2:00 PM
TECHNICAL CLINIC: Prior to the start of the day’s competition, all technical questions, and a general rules clinic will be conducted. *Anyone who does not attend the Technical Conference agrees to accept all decisions made at the Technical conference.
RULES: This is a non-sanctioned power lifting meet. The weightlifting division will be sanctioned by USA Weightlifting. ALL participants are required at weigh in to produce government documents, (i.e. birth certificate, drivers license), and/or Picture ID. Weightlifters must be current USAW Members to compete.
AWARDS: For best in weight class by Division (School Age, Junior, Senior, & Master). Awards for Best Overall Male and Female
For more information contact Meet Director, Joe Micela at 480-813-5477 or email: joe@performanceone.net
2012 Grand Canyon State Winter Games
Weightlifting Competition
OFFICAL ENTRY FORM
PLEASE TYPE OR PRINT ALL INFORMATION CLEARLY
PUSH PULL _______ OLYMPIC WEIGHTLIFTING_________
WEIGHT CLASS: KG (YOU CAN ONLY ENTER ONE)
YEAR OF BIRTH: ____AGE:_______
USAW Member #______________________________ (Not needed for Push Pull Comp)
AGE GROUP: _____SCHOOLAGE (17 & Under) _________JUNIOR (17-20) ___________SENIOR (21-35)_________ MASTER (35+)
NAME: ___________________(LAST) _________________(FIRST)
ADDRESS______________________________________________
CITY _______________STATE_____ ZIP_____
PHONE: ( _____) ______________E-MAIL: ___________________
CLUB AFFILIATION:______________________________________
COACH:________________________________________________
The 2011 Grand Canyon State Winter Games
Olympic-Style Weightlifting
Waiver
PLEASE TYPE OR PRINT ALL INFORMATION CLEARLY
Please enter me in the 2012 Grand Canyon State Winter Games to be held on Sat Jan 28th, 2012 at Performance One Advanced Sports Training in Mesa, Arizona. I certify that I am an amateur in good standing. In consideration of my entry in the competition, I do hereby waive, and release Team Arizona Olympic Weightlifting Club, Performance One Advanced Sports Training, the Grand Canyon State Games, and their 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, for expenses of medical treatment, hospitalization, and other care rendered to me in the event of m injury o r illness, or for any and all other costs, damages or loses suffered or incurred by me or occasioned to me in connection with my travel to and my participation in, the competition and related activities, except that the forgoing waiver and release shall not apply to injuries, damages, and losses resulting from the negligence and/ or loss of sight and medical reimbursement insurance policies maintained by the Organizers. I (and my parent or guardian, if I am a minor), agree that the Organizers and its agents, including Competition personnel, may make judgments (with appropriate input from available medical personnel), as to my treatment, hospitalization or other medical care in the event of my illness or accidental injury in connection with my participation in the competition, should I be disabled or incompetent to make necessary and appropriate decisions concerning such treatment, hospitalization or other care. I authorize the Organizers, its agents and competition personnel to make decisions for me as through they stood in a relationship to me of parent, guardian or nest of kin cannot be timely and conveniently contacted to participate in the making over such judgments.
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 or guardian, if I am a minor), agree that I will be financially responsible for treatment, hospitalization and other medical care rendered to me in the event of my illness, injury or other emergent circumstances in connection with the competition, except to the extent my injuries and medical expenses, if any, are covered by accidental death, dismemberment and/or loss of sight and medical reimbursement insurance policies maintained by the Organizers for my hospital and other medical care of such policies’ limits.
SIGNATURE: _______________________________DATE:_________
UNDER AGE ATHLETES
ATHLETES UNDER 18 YEARS OF AGE HAVE THE FOLLOWING SECTION COMPETED BY A PARENT OR GUARDIAN
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 USAW ACTIVITY UNDER THE ABOVE STIPULATED CONDITIONS.
SIGNATURE: _________________________________DATE:__________