2015 NPC MILWAUKEE MUSCLE MADNESS NPC M3 OFFICIAL ENTRY FORM DATE: Saturday, May 23, 2015 First Name: LOCATION: West Bend High School Auditorium • 1305 E Decorah Rd, West Bend, WI 53095 Last Name: TIME: May 22nd: Mandatory Athlete Check-in Friday 4-8pm at Hampton Inn and Suites at 1975 South 18th Ave • West Bend, WI 53095. May 23rd: MANDATORY ATHLETE MEETING at 9:30am at West Bend High School Auditorium. Prejudge 10:00am. Finals 5:00pm. Phone: ELIGIBILITY: All Competitors: Must be a current and registered NPC athlete and an amateur in good standing. (NPC cards can be purchased at check-in) Masters Men/Women: Must have reached respective birthday by May 23, 2015. Must provide proof of age with birth certificate, driver’s license or State ID. DIVISIONS: Men’s Open Bodybuilding (National Qualifier) Bantam Weight (up to 143.25 lbs) Lightweight (over 143.25 lbs including 154.25 lbs) Middleweight (over 154.25 lbs including 176.25 lbs) Light Heavyweight (over 176.25 including 198.25 lbs) Heavyweight (over 198.25 lbs including 222.25 lbs) Super Heavyweight (over 225.25 lbs) Men’s Physique (National Qualifier) Class A (up to and including 5’ 6”) Class B (over 5’ 6” and including 5’ 8”) Class C (over 5’ 8” and including 5’ 10”) Class D (over 5’ 10”) Women’s Physique (National Qualifier) Class A (up to and including 5’ 6”) Class B (over 5’ 6”) Figure (National Qualifier) Class A (up to and including 5’ 4”) Class B (over 5’ 4” and including 5’ 6”) Class C (over 5’ 6”) Bikini (National Qualifier) Class A (up to and including 5’ 2”) Class B (over 5’ 2” and including 5’ 4”) Class C (over 5’ 4” and including 5’ 6”) Class D (over 5’ 6”) Teen/Masters Teen Men’s Physique Men’s Bodybuilding Age 40+ and Age 50+ Men’s Physique Age 35+ Figure Age 35+ and Age 45+ Bikini Age 35+ ENTRY FEE: $75 for first Division; $75 for each crossover Division. $100 LATE FEE for late entries postmarked after May 16, 2015. No refunds. ATHLETES CANNOT REGISTER THE DAY OF THE SHOW. RULES: Light oil is permitted. Any athlete who competes in pre-judging must also be present for finals. All athletes must exhibit good sportsmanship at all times. No one will be allowed back stage except competitors and contest officials. All current NPC rules apply. Towels will not be provided, please bring your own. MUSIC: All Men’s Bodybuilding and Women’s Physique competitors will provide their own music on a pre-recorded CD. Posing music should be no longer than 90 seconds and posing routines will be performed at the finals. No profanity or vulgar language allowed. PHOTOGRAPHY: Order your package when you register and save! $25 for a personalized CD with your photos from the MMM. Photography provided by Jeff Sygo of SYMI Photography (www.symiphotography.com). TANNING: Spray Tanning will be done by Fifty Shades of Spray at the host hotel. Call 262-707-5618 or email [email protected] to book your appointment. HOST HOTEL: Hampton Inn and Suites • 1975 South 18th Ave • West Bend, WI 53095 • 262-438-1500 For a discount rate, reserve by May 17th and use code: “FC1” TICKETS: Prejudge: $15 – only available at the door. Finals: VIP $35, Reserved $25. TICKETS AVAILABLE ONLINE AT: WWW.NPCM3.COM Age: Gym Affiliation: Street Address: City: State:Zip: ENTRY FEES: $75 Division: Class: $75 Crossover Division: Class: $100 LATE FEE FOR ENTRIES POSTMARKED AFTER MAY 17TH, 2015 $25 FOR PHOTOGRAPHS ON CD Check here to purchase professional show photographs on personalized CD By Jeff Sygo of SYMI Photography. Please note: If you are purchasing a CD, you will need to include a separate check written out to Jeff Sygo. $ TOTAL ENCLOSED Disclaimer: 1) In consideration of your acceptance of this entry, I hereby, intending to be the legally bound for myself, my heirs, executors, and administrators, waive any and all rights and claims for damages I may have against Kevin Tomasini, Stacey Tomasini and/or Demetrius Alecos, the National Physique Committee of the USA, Inc. (“NPC”), the Wisconsin District of the NPC, West Bend High School, West Bend Recreational Department, NPCM3, or its agents, employees, representatives, or assigns of any of the foregoing persons or entities for any and all injuries or damages I may incur while traveling to and from, or participating in this competition. 2) Will comply with all rules and regulations of the host hotel Hampton Inn, West Bend including any rules and regulations prohibiting cooking or food preparation in hotel rooms. The undersigned further agrees that the undersigned will indemnify and hold harmless the NPC and the promoter of the NPCM3 (Kevin & Stacey Tomasini and/or Demetrius Alecos) from and against any damages caused by the undersigned to the host hotel Hampton Inn, West Bend or damages to a guest room or rooms occupied or registered to the undersigned. Finally, the undersigned acknowledges that the undersigned’s failure to comply with any and all rules and regulations of the host hotel Hampton Inn, West Bend or damage to any guest room occupied by or registered to the undersigned may result in disciplinary action against the undersigned, including, but not limited to, suspension as a member of the NPC and or competing in contests sanctioned by the NPC. 3) Certify that I am an amateur in good standing and am eligible to compete in this competition and in the division/divisions in which I have entered. I further agree to abide by all of the decisions of the competition director and the NPC and declare that all of the information contained herein is to the best of my knowledge true, correct, and complete. Print Name: Signature: Email Address: *If contestant is of minority age, this waiver must be signed by parent or guardian. Please mail SIGNED and COMPLETED ENTRY FORMS with ENTRY FEES (Checks made out to Demetrius Alecos) to: Stacey Tomasini • 1800 Tallgrass Cir • Waukesha WI 53188 For questions, please contact Stacey: [email protected] or call 262-707-5618 or log on to WWW.NPCM3.COM