2015 idfa saskatchewan classic entry form – may 2

NATURAL BODYBUILDING, FIGURE & FITNESS MODEL CHAMPIONSHIPS
2015
SASKATCHEWAN
CLASSIC
IDFA PRO-QUALIFIER
ENTRY FORM
LIMITE
DT
SATURDAY, MAY 2, 2015
University Theatre
University of Regina, 3737 Wascana Parkway, Regina, SK
FOR MORE INFO CONTACT US AT:
TEL: 416.363.IDFA (4332) • FAX: 416.363.IDFA (4332)
www.idfa.ca • [email protected]
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CHECK THE APPROPRIATE CLASS BELOW:
MEN’S NOVICE BODYBUILDING
Men’s Novice (classes to be announced)
WOMEN’S FIGURE
Open
Novice
Masters (40 years old and over)
MEN’S OPEN BODYBUILDING*
Lightweight (155 lbs and under)
Middleweight (over 155 lbs to 175 lbs)
Heavyweight (over 175 lbs)
ADDITIONAL INFORMATION
IDFA Pro-Qualifier: An IDFA Pro Card will be
awarded to the Overall Open Winners.
Novice Eligibilty:
1. Competitor has not placed in the top 3 in an
Open division in any organization.
2. Competitor has not placed top 3 in the
Novice division in an IDFA sanctioned event.
Women’s Figure/Fitness Model/Bikini Classes:
If more than 10 competitors there will be 2 classes:
SHORT (5'4" and under) & TALL (over 5'4").
All Figure / Fitness model/Bikini competitors MUST
fill in "Height" below in REGISTRATION INFO.
All competitors must be at least 18 years of age.
WOMEN’S FITNESS MODEL
Open
Novice
Masters (40 years old and over)
*Classes subject to change based on number of competitors.
MEN’S MASTERS BODYBUILDING
Masters (40 years old and over)
WOMEN’S BIKINI
Open
Novice
MEN’S PHYSIQUE
Novice
Open
REGISTRATION INFORMATION (PLEASE FILL IN ALL INFO & PRINT CLEARLY):
Name
Email
Date of Birth
Phone# (day)
month
day
year
Phone# (night)
Address
City
Prov/State
Height
Postal Code/ZIP
Contest Weight
Men’s
M
Contests (Titles Won and/or Contests Placed in)
Women’s
S
M
“Special Thanks To” (20 words or less):
SPECIAL THANKS WILL BE READ ONSTAGE BY SHOW HOST
TER
REGIS & SAVE
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PAYMENT AMOUNT (SELECT ONE)
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Select
GENERAL ENT
1 CROSSOVER
**
**
2 CROSSOVER
**
3 CROSSOVER
Base Entry Fee
L XLXL
NOTE: Registration cannot be processed until payment is received.
Photos
Crossover Judging Report
*
TOTAL1
*
TOTAL2
*
*
base total + report
base total
TOTAL3
base total + photos
*
TOTAL4
base + photos + report
$1
.00 $1 0.00 +
+
$30.00
+
$80.00 =
$146.90
or
$180.80
or
$237.30
or
$1
.00 $1 0.00 + $40.00 +
$30.00
+
$80.00 =
$192.10
or
$226.00
or
$282.50
or
$316.40
$1
.00 $1 0.00 + $80.00 +
$30.00
+
$80.00 =
$237.30
or
$271.20
or
$327.70
or
$361.60
$1
.00 $1 0.00 + $120.00 +
$30.00
+
$80.00 =
$282.50
or
$316.40
or
$372.90
or
$406.80
N/A
$271.20
* All TOTALS are in CND (Canadian Funds) and include %13 HST ** CROSSOVER: Masters can crossover to OPEN or NOVICE class. Fitness Model can crossover to Figure and vice-versa
Bodybuilding can crossover to physique and vice-versa. Bikini can crossover to fitness model and vice-versa
METHOD OF PAYMENT (SELECT ONE)
Registration cannot be processed until payment is received.
CHEQUE / MONEY ORDER
(payable to IDFA)
OR
FREE T-SHIRT!!
Athletes receive one FREE Competition T-shirt
on day of event. Please fill in your T-shirt size above.
FAX TO: 416.363.IDFA (4332)
IDFA DRUG TESTING & WAIVER (PRINT NAME, SIGN AND DATE IN BOTH AREAS)
I,
, fully understand the condition of entering the 2015 IDFA Saskatchewan Classic
is that I have not taken any prohibited substances identified in The 2015 Prohibited List, World Anti-Doping Code
(WADC) and I have reviewed the IDFA Drug Testing Policies and Procedures as seen on the Official IDFA website.
SIGNATURE
DATE
WAIVER (PLEASE SIGN & DATE BELOW): By your accepting my application to the 2015 IDFA Saskatchewan Classic Natural Bodybuilding, Figure & Fitness Model
Championships, along with my non-refundable entry fee, I hereby intend to be legally bound for myself, my heirs, executors and administrators, and waive and release any and all
rights and claims for damages I may have against Shaun Campbell, the University Theatre, University of Regina, and International Drug Free Athletics (IDFA). This also includes all
sponsors, agents, representatives and assigns for any and all injuries and/or losses suffered by me as a result of my participation and/or attendance and traveling to the 2015 IDFA
Saskatchewan Classic Natural Bodybuilding, Figure & Fitness Model Championships, May 2, 2015. These damages include, but are not limited to, published photographs that I may find to be
unattractive or editorial which I may construe as being misrepresentative. I also grant IDFA Saskatchewan Classic, International Drug Free Athletics (IDFA), IDFA.ca,
and Shaun Campbell permission to use photos, videos or any likeness of myself to promote any future contests, videos, magazines or any other media involved with
future and present contests for the purpose of promotion and/or sales of these media, without any compensation to myself, as condition of my entering the event. I also agree, by
my own free will and without duress, to take a polygraph test and/or voice analysis test and submit a urine sample upon request. I also agree to the outcome of the tests results from
the polygraph examiner, voice analysis examiner and urinalysis center. I will abide by all International Drug Free Athletics (IDFA) rules and show good sportsmanship. By signing and
submission of this form I am stating that I am Drug Free and will abide by the International Drug Free Athletics (IDFA) drug test policies and procedures.
SIGNATURE
DATE
MAIL TO: International Drug Free Athletics (IDFA)
2211 Brant Street, PO Box 20084, Burlington, ON, L7P 0A1