2015 Fortius Open / San Diego Weightlifting Championships Saturday and Sunday, May 2nd and 3rd, 2015 Venue / Sanction: Sanction Number: 33-15-18 CrossFit Fortius 4903 Morena Blvd, Suite 1206/1207/1208 Rose Canyon Business Park San Diego, CA 92117 Meet Directors: David Miller & Jesse Malcomb (443) 413-7866 [email protected] Entry Fee / Requirements: (Organizing committee and/or USAW reserve right to refuse entry) Individual Registration: $60 – LIMITED TO 200 TOTAL ATHLETES Team Registration: $80 To complete registration, you MUST: 1) Visit: http://bit.ly/1FbL1bi to pay 2) Fill out the last page of this form out and either scan/email to [email protected] BEFORE REGISTERING, PLEASE CONFIRM YOU CAN AND WILL MEET ALL OF THE FOLLOWING REQUIREMENTS: 1) If you are not already a member, you must register as a USAW Member (https://www.usaw.hangastar.com/Login.aspx) prior to competition and have your USAW # and ID with Date of Birth on hand at the weigh-in (please note that if you are not already a USAW member, this process will cost up to $50 – good for 1 year) 2) You will adhere to the IWF Code of Conduct (2.8) and the Fortius Code of Conduct. Any athlete, coach, or spectator that violates this code (especially showing disrespect, aggression, or violence towards any official, referee, or meet volunteers/directors) may be ejected from the competition with no refund at the SOLE discretion of the meet directors. 3) Respect the facility, our equipment, and our neighbors. Please make sure to park on the top level of the business park or risk being towed. Deadline for Registration: April 19th, 2015 Tentative Event Schedule*: Saturday Gender Men Women Men Women Men Women Weight Classes (in kg) 56, 62 48, 53 69 58 77 63 Weigh In 6:00 AM 8:00 AM 10:00 AM 12:00 PM 2:00 PM 4:00 PM Lift 8:00 AM 10:00 AM 12:00 PM 2:00 PM 4:00 PM 6:00 PM Sunday Gender Women Men Women Men Men Men Weight Class(es) 69 85 75, 75+ 94 105 105+ Weigh In 6:00 AM 8:00 AM 10:00 AM 12:00 PM 2:00 PM 4:00 PM Lift 8:00 AM 10:00 AM 12:00 PM 2:00 PM 4:00 PM 6:00 PM *SUBJECT TO CHANGE BASED ON REGISTERED LIFTERS, a revised schedule will be sent out after April 19th Costume Requirements: If this is your 1st or 2nd competition, a singlet is NOT required. However, you must wear tight fitting shorts and a tight fitting t-shirt or compression shirt. For everyone else, singlet is required. Awards: Cash Prizes (*subject to change based on total number of entries) Top 3 Overall Male and Female Senior (Open) Division (based on Sinclair formula) 1st: $400 2nd: $200 3rd: $100 Top 3 Overall Junior Lifters (Male and Female) 1st: $175 2nd: $125 3rd: $75 Top 3 Overall Masters Lifters (Male and Female) – based on Sinclair-Malone-Meltzer formula 1st: $175 2nd: $125 3rd: $75 Plus sponsor prizes for each *if available Medals for Top 3 in Male / Female for Each Weight Class for: Senior Junior Masters Best Overall Lifter Male / Female Plaques (based on Sinclair formula) For Reference: Weight Categories for Women: 48kg (105.6#), 53kg (116.6#), 58kg (127.6#), 63kg (138.6#), 69kg (151.8#), 75kg (165#), 75+kg (165+#) Weight Categories for Men: 56kg (123.2#), 62kg (136.4#), 69kg (151.8#), 77kg (169.4#), 85kg (187#), 94kg (206.8#), 105kg (231#), 105kg (231+#) USA Weightlifting and IWF Rulebook (for technical rules for this competition): http://www.iwf.net/wp-content/uploads/downloads/2013/10/IWF-TCRR-September2013.pdf Referee Clinic: Fortius Weightlifting will hold a short (and FREE) USAW Local (LWC) Referee Clinic with test Thursday, April 30th at 6pm. Those who pass may sit to referee this competition and earn their LWC Level Referee status! 2015 Fortius Open / San Diego Weightlifting Championships Saturday and Sunday, May 2nd and 3rd, 2015 Team Competition Information / Registration Team Requirements: 8 Total Team Athletes Maximum Men = Up to 4 Athletes Women = Up to 4 Athletes (2 maximum per weight class) Team Points: Based on placement in weight class 1st Place = 10 pts 2nd Place = 8 pts 3rd Place = 7 pts 4th = 6 pts 5th = 5 pts 6th = 4 pts 7th = 3 pts 8th = 2 pts 9th = 1 pt Cost: $80 per team * Each member of your team will then pay the $60 individual registration, and be eligible for individual awards / prizes as well. Awards: Top 3 Overall Teams (*subject to change based on total number of entries) 1st: $500 2nd: $250 3rd: $150 Top 3 Male & Female Team Plaques Registration: 1. Visit: http://bit.ly/1FbL1bi to pay 2. Email your team name and list of members competing (with their gender and weight class) to Meet Director ([email protected]) ****BRING YOUR USAW CARD WITH YOU TO THE MEET**** Please enter me in the _________ kg category for this meet. In consideration of my entry in the 2015 Fortius Open Championships (individually and collectively, the “competition”). I certify that I am sufficiently physically fit to participate in the competition and I (and my parent or guardian, if I am a minor) hereby waive and release USA Weightlifting (the USAW), its directors, officers, officials and agents, the Southern Pacific LWC, the Fortius Weightlifting Team, the CrossFit Fortius, and the competition’s sponsors and organizers of and from any cause of action, loss, liability, claim demand or expense of any kind whatsoever which I or my heirs or personal representatives may have bodily injury or illness and for any other cost, damage or loss suffered or incurred by me or on my behalf in connection with my travel to and from, and my participation in, the Competition and all related activities. The foregoing waiver and release shall not apply to injuries, damages and losses resulting from injuries or medical expenses covered by accidental death, dismemberment and/or loss of sight and medical insurance policies maintained by the USAW. I (and my parents or guardian, if I am a minor) agree that the USAW and its agents, including the Competition’s sponsors and organizers, may make judgments (with appropriate advice from available medical personnel) with respect to my treatment, hospitalization or other medical care in the event of my illness or accidental injury in connection with my participation in the Competition, if I become disabled or incompetent to make necessary and appropriate decisions for me as though they stood in a relationship to me of parent, guardian or next of kin if circumstances require the USAW, its agents or the Competition’s sponsors or organizers to make such judgments, and my next of kin (or my parent or guardian, if I am a minor) hereby release and agree to hold the USAW and its agents, the Fortius Weightlifting Team, the CrossFit Fortius, and the Competition’s sponsors and organizers harmless from and against any expense, cause of action, liability, claim, demand or expense arising from good faith judgments made by the USAW, its agents and/or the Competition’s sponsors and organizers concerning the treatment, hospitalization and/or medical care in the event of any illness, injury or other emergency circumstance in connection with the Competition. I (and my parent or guardian, if I am a minor) agree that I (and my parent or guardian, if I am a minor) will be financially responsible for treatment, hospitalization and other medical care rendered to me in the event of my illness, injury or other medical emergency circumstances in connection with the Competition, except to the extent my injuries and medical expenses, if any, are covered by accidental death, dismemberment and/or loss of sight and medical reimbursement insurance policies maintained by the USAW for my benefit, in which event I (and my parent or guardian, if I am a minor) nevertheless will continue to be financially responsible for expenses of treatment, hospitalization and other medical care in excess of such policies’ limits. PLEASE TYPE OR PRINT ALL INFORMATION CLEARLY NAME_________________________________________ DATE OF BIRTH________________AGE____________ ADDRESS___________________________________________________________________ (Street) (City) (State) (Zip) PHONE _________________________ EMAIL ADDRESS_____________________________ USAW NUMBER__________________USAW MEMBER EXP. DATE________ TEAM (if competing in the team competition)____________________________________________ WEIGHT CLASS_____________KG BEST COMPETITION TOTAL ____________KG (if this is your 1st meet, write “1st Meet”) SIGNATURE___________________________________________ DATE_______________ ATHLETES UNDER AGE 18 MUST HAVE THE FOLLOWING SECTION COMPLETED BY THEIR PARENT OR LEGAL GUARDIAN. (For athletes of minority age) I have explained to my son/daughter the aforementioned release and activity and their ramifications, and I further consent to his or her registration for this USAW activity under the conditions and their ramifications, and I further consent to his or her registration for this USAW activity under the conditions stipulated above. SIGNATURE___________________________________________ DATE________________ PRINTED NAME__________________________________PARENT_____GUARDIAN_____
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