2014 BCPA Provincial

Powerlifting and Bench Press Championships

Date: Saturday-Sunday, June 21-22, 2014

Location: Waterfront Theatre, 1412 Cartwright Street, Vancouver, BC

Schedule: Saturday
Men's Powerlifting Weigh In: 9:00 a.m. Lifting: 11:00 a.m.
Sunday
Special Olympics Weigh In: 8:00 a.m. Lifting: 10:00 a.m.

Bench Press Weigh In: 10:00 a.m. Lifting: 12:00 p.m.

Women’s Powerlifting Weigh In: 12:00 p.m. Lifting: 2:00 p.m.

****Times are subject to change based on registration numbers****

Sanctioned By: Canadian Powerlifting Union (CPU) and British Columbia Powerlifting Association
(BCPA)

Rules: IPF Rules, drug testing to IPF Specifications

Eligibility: Open to all current (2014) CPU members.

Special Olympics must be registered with the BC Special Olympics
CPU Membership from the BCPA Registrar must be obtained in time for the
registration deadline. See BCPA website (www.bc-powerlifting.com) for
membership application and payment details.

Entry Fee: Open, Master, Junior $75 Powerlifting (3 Lift) $95 Powerlifting (3 Lift) and
(includes T-Shirt) Bench Press Only
Sub-Junior $60 Powerlifting (3 Lift) $80 Powerlifting (3 Lift) and
Bench Press Only
Special Olympics $55
Bench Press $65 (all ages)

Awards: Medals - 1st, 2nd and 3rd Place in each weight class
Best Lifter - Open/Master, Junior/Sub-Junior and Bench Press Only
(min. 5 per age category)

Make payment to: BCPA (certified cheque or money order)

Meet Director: Joe Oliveira

(604)734-2932 Email: olivejoe1969@gmail.com

Entry Deadline: MUST BE RECEIVED BY JUNE 6, 2014

Please Note:
Entry Form - late entries will not be accepted, so please send entry form early. NO REFUNDS AFTER ENTRY DEADLINE.
Weight Class - medals are scripted with the weight class you have entered; any changes to your weight class will be the responsibility of
the lifter to have medal inscription changed.
Coaching - will be limited to 1 coach per lifter.
Warm Up Area - only for lifters and coach; all lifters must ensure the use of collars when warming up.
Drug Testing - This is a drug-tested contest. Once a lifter has weighed in, he/she accepts the IPF drug-testing procedure IN FULL, and
from that moment on is in the contest. The lifter may not exit from the contest before its completion. EVEN IF HE/SHE BOMBS OUT! This
may be viewed as a refusal to submit a sample for anti-doping control, and if so, will result in immediate disqualification from the contest and
suspension from the BCPA/CPU.
 SEND THIS PAGE TOGETHER WITH ENTRY FEE TO:
Joe Oliveira, 8119 Cartier Street, Vancouver, BC V6P 4T6

Name: CPU Card #

(Check here if membership application form
is in process with the Registrar)

Date of Birth: Email:

Required

Men’s Weight Class (kg) - Circle One:

53 (Sub-Junior/Junior) 59 66 74 83 93 105 120 120+

Women’s Weight Class (kg) - Circle One:

43 (Sub-Junior/Junior) 47 52 57 63 72 84 84+

Age Category - Circle One:

Open Master: I II III IV Junior Sub-Junior

Competition - Circle One:

Powerlifting (3 Lift) Bench Press Only Powerlifting (3 Lift) and Bench Press Only

Category - Circle One: Equipped Unequipped

T-Shirt Size: T-Shirt: S M L XL XXL XXXL

Colour: White Black Red Pink

Women’s
Fitted T-Shirt: XS S M L XL

Colour: White Black Pink

Additional T-Shirts: $20

Release of Liability, Waiver of Claims, Assumption of Risks and Indemnity Agreement

BY SIGNING THIS DOCUMENT YOU WILL WAIVE CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE.
PLEASE READ CAREFULLY.

Disclosure and Participant’s Assumption of Risks

In consideration for permission granted by British Columbia Powerlifting Association to participate in its
Provincial Powerlifting Meet (the “Activities”) I, the undersigned myself, my heirs, executors and administrators,
hereby acknowledge and agree to waive any and all claims that I have or may in the future have against the
Canadian Powerlifting Union, British Columbia Powerlifting Association, Granville Island Cultural Society,
Waterfront Theatre, the City of Vancouver, the Province of BC and any of its employees, organizers, volunteers
and sponsors of this competition, (the “Releasees”) and to release the Releasees from any and all liability for
any loss, damage, expense or injury including death, that I may suffer, or that my next of kin may suffer as a
result of my participation in any Activities sponsored or organized by the Releasees, DUE TO ANY CAUSE
WHATSOEVER, INCLUDING NEGLIGENCE, BREACH OF CONTRACT OR BREACH OF ANY STATUTORY
OR OTHER DUTY OF CARE, INCLUDING ANY DUTY OF CARE OWED UNDER THE OCCUPIERS'
LIABILITY ACT, RSBC 1996 c. 37 on the part of the Releasees and also including the failure on the part of the
Releasees to safeguard or protect me from the risks, dangers and hazards of participating in the activities.

I realize that Powerlifting is a high risk sport and that I could be injured. I certify that I am in good physical health
and that I have no serious health problems and that I assume full responsibility for such conditions. I accept that
I am fully responsible for my well being and safety in the warm up room, on the lifting platform and while I am
competing at this event. I am also aware that I am responsible for the actions of any coach and entourage that
attends this contest in my support.

I HAVE READ THIS WAIVER AND RELEASE OF LIABILITY FORM, FULLY UNDERSTAND ITS
TERMS, AND I UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT,
AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

Signature: Phone:

Parent/Guardian: (if under 18 years of age)

Date: