2006 WPC The Open Estonian (Baltics) Championship in a bench presss

World Powerlifting Congress

Estonian Powersport Federation

ENTRY FORM

First Name: ____________________            Last Name: ____________________

Birthday: _____________          ___            Nation: _______________  _______

Address: ___________________________________________________               

Bench-press:                                                                   O   

Weight class: ________ kg           Women:  O             Men:   O

Open class:                                                            O         Age: _________

Junior class:                                                           O         Age: _________

Teenager class:                                                      O         Age: _________

Master class:                                                          O         Age: _________

Participation at your own risk, danger and responsibility!
Organizer will not assume any liability!
Minors allowed only with consent of parent or guardian!

Entry fees:             Bench-press                                        € 25, 00

Entry Deadline:                          November 10, 2006 (after November 10, 2006 - Entry Fees + €5,00)

 

Please send the ENTRY FORM to:   31022 Estonia

Ida-Virumaa

Kohtla-Jarve

Estonia pst. 28-21

Sergey Baumer

email: sergei.baumer@gometal.ee; info@gometal.ee; tulenn@mail.ru

tel/fax: +372 53479121; +372 55515096

Date: _____________                  Signature: __________________