March 14, 2015 UPA Michigan State Powerlifting Championship Flat

Michigan State Powerlifting Championships
Raw, Equipped & CrossFit
Saturday, March 14, 2015
2016 Arnold Qualifier
Meet Director:
JJ Thomas-734-642-7877 or [email protected]
or on under 2015 UPA/UPA-AD MI State Powerlifting
Equipped & Raw: Full Power, Ironman, and Squat, Bench & DL only.
CrossFit(Raw Rules apply)
Detroit Barbell. 24787 Van Horn. Flat Rock, MI 48134
Lifting Session:
Saturday, March 14, 2015 @ 9:00am.
Updates will be posted on, under 2015 UPA/UPA-AD Michigan
State Powerlifting Championships
Sanctioned by the United Powerlifting Association (UPA) Check for information and rulebook.
UPA-AD is a drug tested division. We will be drug testing this division
One piece lifting suit required.
Raw or Equipped. Knee wraps, belts and wrist wraps are allowed in the Raw
division. Equipped, please check the UPA Rule Book.
60 spots available ONLY!
Friday, March 13: 9am-10:30am @ Detroit Barbell(17608
Telegraph. Brownstown, MI 48174
& 6pm-7pm @ Woodhaven High School
Saturday, March 14 weigh in: 7:30am-8:00am @ Woodhaven
High School
You MUST be weighed in by 60 minutes before the meet or you CANNOT lift,
Open to all UPA members. Registration is $30 per card. Include your registration
money with this entry form if you need to become a member--application to be
filled out at the weigh-ins. Current members must present their cards at
weigh-ins or they will have to buy another one.
Entry Fee:
$70, $60 for Teen Division
$40 for each additional division.
Meet Shirts are included with entry fee for FREE, S-4XL,
please mark your size
Entry fee MUST accompany entry form when mailed. NO REFUNDS.
The entry deadline is March 2, 2015. $30 late fee will be assessed if entry is
postmarked after the above date.
Lifters will also be eligible to break UPA & UPA-AD National Records. Lifters
will also establish/break all UPA State Records for the division they lift in.
Best Lifter awards for:
Men’s UPA Full Power Raw, Men’s UPA-AD Full Power Raw, Men’s
UPA/UPA-AD Full Power Equipped, Women’s Full Power Raw, Women’s
Full Power Equipped, Men’s Bench Only Raw, Men’s Bench Only Equipped,
Women’s Bench Only Raw, Women’s Bench Only Equipped
Medals will be given to 1st-3rd place in all Men’s and Women’s classes.
Best Lifters are based on Schwartz formula only!
Spectator Fee:
$10; Children 12 and under are free.
Food & Drinks will be provided to the lifters free of cost.
This meet will sell out and it is first come, first serve
60 spots only!
This is also a fundraiser for the Woodhaven High
School wrestling team. $10 for every entry will go
towards their team!
Mail this page along with your entry fee to the following address:
Detroit Barbell. 17608 Telegraph. Brownstown, MI 48174
Make Checks Payable to:
Detroit Barbell
In consideration of the acceptance of this entry thereby for myself, my heirs, executors, and administrators waive and release
any and all claims and damages I may have against the U.P.A., Jeremy Thomas, Harlan Brandenburg, Detroit Barbell, their
representatives, successors, and assigns for any and all injuries or bodily harm that I may suffer while competing at the 2015
UPA/UPA-AD Michigan State Powerlifting Championships. I attest and verify that I have full knowledge of the risks
involved with my participation in this event, and that to the best of my knowledge I am physically fit and able to participate
in this event.
Signature: _____________________________________________________ Date: _______________
Parent/Guardian (if under 18): _____________________________________ Date: ________________
Print Name: ________________________________________________________________________
Address: ________________________City: _________________ State: _______ Zip Code: _______
Phone: (_______)____________________ Email: __________________________________________
Date of Birth: _________________________ Age : _____________ Gender: ____________________
Circle Event:
Full Power
Bench Only
Squat Only
Deadlift Only
Circle division below:
Circle Weight Class:
Men: 114, 123, 132, 148, 165, 181, 198, 220, 242, 275, 308, SHW
Women: 97, 105, 114, 123, 132, 148, 165, 181, 198, SHW
Circle Division(s) Entered:
A $50 fee for each additional sanction/division.
Sanction: UPA & UPA-AD
Teen 13-15, 16-17, 18-19, Junior 20-23, Open, Submaster,
Master 40-44, 45-49, 50-54, 55-59, 60-64, 65-69, 70-74, 75-79, 80-84, 8589 etc...
UPA Membership:
Entry Fee:
Official Meet T-shirt’s
Late Fee: