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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 ***
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