2013 NYC OPEN Menís and Womenís weightlifting Championships
Conducted by Weightlifting.org, Inc. & the Metropolitan Local Weightlifting Committee (Met LWC) of USA Weightlifting (USAW) Ė Sanctioned by USAW Sanction # 06-13-01
OFficIal Entry Blank For the 2012 New York city open
MeN's AND WOMEN's Weightlifting Championships
CATEGORY: M/W____kg. YOB___________ E-mail:____________________________________
REQUEST AND RELEASE
I, the undersigned, hereby request permission to enter the premises of the Professional Athletic Performance Center, at 645 Stewart Ave., Garden City, N.Y., and to participate in the weightlifting competition(s) to be held there on Sunday March 24, 2013. I have inspected the premises and I know the substantial risks and dangers involved in the said activities, and that unanticipated and unexpected dangers may arise during such activities and I assume all risks of injury to my person and property that may be sustained in connection with the stated and associated activities in and about the premises and in traveling to and from the said premises and activities.
In consideration of the permission granted to me to enter the premises and participate in the stated activities, I do hereby, for myself, my heirs, administrators and assigns, release, remise and discharge Weightlifting.org, Inc., the Metropolitan Local Weightlifting Committee of the USAW and the individual members thereof, the Professional Athletic Performance Center, owners, operators, sponsors and sanctioners of said premises, of the activities and of the equipment therein, and their respective committees, servants, agents, officers, representatives and officials, and all other participants in the stated activities of and from all claims demands, actions and causes of action of any sort, for injuries, damages and/or losses sustained by my person and/ or property during my presence in said premises and participation in the stated activities, regardless of who is at fault or whose negligence caused such a loss or injury, even if the loss or injury is caused by the fault or negligence of the Metropolitan Local Weightlifting Committee of the USAW and the individual members thereof, and any other of the parties mentioned herein as being released.
I represent and certify that my true date of birth is stated below, and, if I am under the age of 18 years, I do represent and certify that I have the permission of my parents and/or legal guardians to participate in the stated activities, that they have full knowledge thereof and that at least one has read, understood and signed this request and release.
I certify that my attendance and participation in the stated activities is voluntary, and that I am not, in any way, the employee, servant, or agent of the owners, operators, sponsors or sanctioners of the premises and/or activities therein. I further agree that I have reviewed, understand and agree to abide by the rules and regulations of this program. I understand that Weightlifting.org, Inc. and the Metropolitan LWC each reserve the right to reject any entry.
I HAVE READ AND UNDERSTAND THE FORGOING REQUEST AND RELEASE
If you are under 18 your parent/legal guardian must sign below
SIGNATURE OF PARENT/GUARDIAN________________________ DATE____________
Weightlifting.org, Inc. and the MET LWC Reserve the Right To Reject Any Entry