IronDawg Open Record Setters  Bench Press Championships.
January 23, 2010
Athens Moose Lodge
185 Ben Burton Rd.
Athens, Georgia, 30622 USA



City _______________________State__________Zip______________________

Phone________________________________ Birth date____________________


Check all appropriate categories in each column below:

Raw___                  Equipped____

__Bench Meet

__Both Meets

__Team Entry

Team Name:


___Junior 20-23


___Sub-master 35-39



Weight Class: Women:




Release From Liability. Read this carefully.
By signing this you will be giving up important rights. In consideration of my acceptance of my entry form in this powerlifting/benchpress competition, I understand that I am legally bound for not only myself but also for my heirs, my executors, and my administrators. In signing this release from liability I waive and release L B Baker,  IronDawg Power,  The American Powerlifitng Committee, The Athens Moose Lodge and staff, all Officials, Referees, Spotter/Loaders and any other person or firm taking part in this competition from any and all liability which may arise from this competition. I understand all of the above for my acceptance of my entry in this competition. By signing this entry form I affirm that all the information on this form is correct.

Signature________________________________________________________    APC Card Number_______________

Parent or guardian if under 18________________________________________

24 hour weigh-in starts Friday at 10:00AM - 12:00 and 6:00PM - 8:00PM at the Athens Moose Lodge.

Contest starts at 10:00AM Saturday at the Athens Moose Lodge

Bench Press $70.00 - Benchpress- 2 classes $120.00

Entry deadline January 15,  Late entry $20.00

Send check payable to Irondawg Power and entry form to: Irondawg Power, P O Box 40, Bogart, Ga. 30622, Phone  770-713-3080