Bench Pressing For Presents 2016 ~ Toys For Tots Fundraiser

1. Bench Pressing For Presents ~ Benefitting Toys For Tots
1:00PM Saturday December 10, 2016
Name: __________________________________________Phone: _______________________
DOB: ________Email: ________________________________________Shirt Size: _________
CLASSES (Check One): Male __________ Female __________
Sub Junior (14 – 18 y/o): _________Junior (19 – 23 y/o) __________
Open (14 & Over) ___________Master’s 40 & Over ____________
Entry Fee: (1) New, unwrapped toy per class entered
Weigh In: 11:00am - Opening weight will be declared at weigh in
Commands: Lower, Press, Rack
Equipment: This is a “Raw” bench press competition. Wrist wraps and belt only.
Formula: Schwartz Malone Formula
Location: Impact Fitness Center Suite 123, 40 Main St Biddeford, Maine 04005
Phone: (W) 207-602-6242 / (C) 207-229-5441
Email: scottf@impactfc1.com
Registration Deadline: Saturday December 3, 2016
Waiver: I hereby intend to be legally bound for myself, my heirs, executors and administrators, and w aive and release any
and all rights and claims for damages I may have against the facility ow ners, the promoters, and any sponsors, agents, or
representatives forany injuries suffered by me as a result of my participation and/or attendance at this competition. I
hereby grant the promoters, any approved magazine, video or entertainment organization and all of their agent’s
successors, licensees and assignees, the right to photograph or otherw ise reproduce my voice, appearance and name
and exhibit, distribute, transmit and/or otherw ise exploit any and all media, including w ithout limitation, by means of still
photography, motion pictures, radio, television, printing, or any other medium now know n or hereafter devised, including
audio w ith respect to any merchandising, advertising, and/or publicity and the right to use my name and information about
me in connection w ith any of the foregoing. No further compensation shall be payable to me at any time in connection
therew ith. Nothing contained herein shall be deemed to obligate, Impact Fitness Center and/or any magazine, video or
any approved video entertainment organization to photograph or otherw ise reproduce my voice, appearance or name, or
to make use of any of the rights granted herein. I also understand that the aforementioned rights may be reassigned at
any time w ithout further comment. I agree to abide by the decision of the contest promoters concerning my participation in
an Impact Fitness Center contest. I hereby w aive and release any claims or demands against the Impact Fitness Center,
it’s representatives, sponsorsand promoters that may arise out of my participation in a Impact Fitness Center promoted
event
I have read, understand, and agree to the above terms
Name: ________________________________________
Signature: _____________________________________
If under 18, parent’s name: ________________________
Parent’s Signature: ______________________________