2004 X-Treme Strongman Showdown
February 7th & 8th,
Shriner’s Auditorium – Wilmington, MA
Entry Form
Name:
_________________________________________________________________________
Address:
______________________________________________________________________
City / State:
____________________________________________Zip:_________________
Phone:
_________________________E-mail_________________________________________
Age: __________ Height:
_________ Weight: _________
Competitive Division (check
one): Professional_____ Amateur_____ Women’s_____
Amateurs please indicate
weight class:
200# and under____ 201#
through 250#_____ 251# and over_____
Most recent
Accomplishments/Titles Held/Achievements in Strongman Events and other
sports:
Please use reverse side
or separate sheet of paper to list. This is very important for our
sponsors and announcers! Pros Especially!!!
In consideration of your acceptance of this entry, I hereby waive and
release intending to be legally bound for myself, executors,
administrators, and my heirs, all rights and claims for damages I may have
against Art McDermott, Highland Strength & Fitness, Shriner’s Auditorium,
Aleppo Temple Shrine Activities, Inc., Aleppo Temple A.A.O.N.M.S., The
Imperial Council A.A.O.N.M.S., Shriner’s Hospital and its Affiliated
Corporation, the sponsors, the officials, employees, representatives or
assigns of any of the foregoing reasons of injury or damage I might incur
while traveling to or from or participating in the competition. If under
18 legal guardian signature required.
Signature Required:
__________________________________________________________
Guardian Signature: (if
necessary)____________________________________________
Entry Fee: Professional
- $100.00 Women - $75.00 Amateur - $50.00
Make checks payable to:
Shriner’s Auditorium
Mail Entry Fee and Form to:
Shriner’s Auditorium
Attn: Strongman Show
99 Fordham Road
Wilmington, MA 01887
Note: This is a NASS and IFSA/USA sanctioned event. All participants
must have an active pro or NASS card, depending upon your division.
*** APPLICATION DEADLINE IS JANUARY 17TH, 3 WEEKS PRIOR TO
THE SHOW ***
