2009 REDWOOD EMPIRE CHAMPIONSHIPS

NOTICE: PRE-REGISTRATION ONLY

2009 REDWOOD EMPIRE CHAMPIONSHIPS
JULY 11th, 2009
ENTRY FORM

Please complete this form and mail it with your entry fee of $40.00 by July 1st, 2009.
Entry fees are non-refundable and cannot be transferred. Incomplete entries will not be accepted.

Please make checks payable to Freddie Myles. Send entries to:

Myles Ahead Fitness
245 Southwest Blvd
Rohnert Park, CA 94928

I agree by signing this form for the 2009 Redwood Empire Championships (USAW/PWA #38-09-03), that I will abide by all of the rules of USA Weightlifting (USAW) and the Pacific Weightlifting Association (PWA). I will not hold responsible USAW, the PWA, the Officials and Organizers of this event or Myles Ahead Fitness for any injuries that may happen to me while competing in, or while traveling to and from this event.
SIGNATURE_______________________________________________ DATE_________________ SIGNATURE OF PARENT (IF UNDER 18 YEARS OLD)___________________________________ PLEASE PRINT THE FOLLOWING VERY CLEARLY: NAME____________________________________________ PHONE #(____)_______________ ADDRESS________________________________________CITY________________ZIP_______ EMAIL ADDRESS________________________________________________________________ BODYWEIGHT CLASS_____________________KG YEAR OF BIRTH _____________________ MALE/FEMALE __________________ MASTERS? (Y/N)____________ COMMEMORATIVE T-SHIRT (CHOOSE ONE): S_____ M_____ L_____XL______ CURRENT USAW CARD NUMBER_______________ EXPIRATION DATE____________________ USAW CLUB_____________________________________________________________________ YOU MUST HAVE A CURRENT USA WEIGHTLIFTING MEMBERSHIP TO COMPLETE THIS ENTRY. Any questions may be directed to Freddie Myles (707) 664-1138


Please complete this form and mail it with your entry fee of $40.00 by July 1st, 2009. Entry fees are non-refundable and cannot be transferred. Incomplete entries will not be accepted.

Please make checks payable to Freddie Myles. Send entries to:

	Myles Ahead Fitness 245 Southwest Blvd Rohnert Park, CA 94928



I agree by signing this form for the 2009 Redwood Empire Championships (USAW/PWA #38-09-03), that I will abide by all of the rules of USA Weightlifting (USAW) and the Pacific Weightlifting Association (PWA). I will not hold responsible USAW, the PWA, the Officials and Organizers of this event or Myles Ahead Fitness for any injuries that may happen to me while competing in, or while traveling to and from this event.
SIGNATURE_______________________________________________ DATE_________________ SIGNATURE OF PARENT (IF UNDER 18 YEARS OLD)___________________________________ PLEASE PRINT THE FOLLOWING VERY CLEARLY: NAME____________________________________________ PHONE #(____)_______________ ADDRESS________________________________________CITY________________ZIP_______ EMAIL ADDRESS________________________________________________________________ BODYWEIGHT CLASS_____________________KG YEAR OF BIRTH _____________________ MALE/FEMALE __________________ MASTERS? (Y/N)____________ COMMEMORATIVE T-SHIRT (CHOOSE ONE): S_____ M_____ L_____XL______ CURRENT USAW CARD NUMBER_______________ EXPIRATION DATE____________________ USAW CLUB_____________________________________________________________________ YOU MUST HAVE A CURRENT USA WEIGHTLIFTING MEMBERSHIP TO COMPLETE THIS ENTRY. Any questions may be directed to Freddie Myles (707) 664-1138