USAWA

By Frank Ciavattone

Meet Director: Mark Raymond – owdmr@aol,com (718)-801-0947

Date: May 13, 2023

Weigh In: 7:00-8:30am

Lifting begins at 9:00 AM

Entry Fee: $75.00

Entry deadline: April 22, 2023 No Exceptions

USAWA Membership for 2023 is required

To Enter, please fill out the form below, make checks payable to Mark Raymond and mail to:

Mark Raymond

635 N Main Street

Mansfield, MA 02048

Phone: (781) 801-0947

Meet Site: Frank’s Barbell Club

                204 East Street

                East Wapole, MA 02032

_______________________________________________________________________

Please enter me in the 2023 USAWA Heavy Lift Championships

Name__________________________________Anticipated Weight Class______________

Address_______________________City_______________State________Zip_________

Phone ______________________DOB_______________Age________________

Division entering(age group, Open and 40______________________

In consideration of acceptance of my entry, I hereby release all claims for damages, losses, and injuries that I might hold against the USAWA, Met Director, Mark Raymond and all officials and assistance  and Frank’s Barbell Club while taking part of the 2023 USAWA Heavy Lift Championship.

Signature______________________________________________________________

If you are under 18 years of age, a parent is required

to sign _______________________________________________________________