Application for a
Required for ALL National Records, |
Send to: CPU RECORDS CHAIRMAN Mike Armstrong 4709 Fordham Cres. SE Calgary, Alberta, T2A 2A5 |
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Please Note:
- Any records noted on contest results will be marked as Pending until a record application
is received. - Pending notice will be removed only when: a) A record application is received from the lifter b) a record application FEE of $75 is received from the lifters provincial organization. (the record setting lifter may be charged back by the provincial org) The Record Application and Fee must be received within 60 days of the contest or it will be removed. If your record application has been sent in, but the record still shows as Pending, please check with your provincial org regarding the fee payment. |
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Name ________________________________________ Phone No. ____________________________ Address _____________________________________ City _________________________________ Province ____________________________________ Postal Code __________________________ Email _______________________________________________________________________________ Age ______ Date of Birth - Month ______ Day ______ Year ______ Male [ ] Female [ ] Name of Contest _____________________________________________________________________ Location of Contest ___________________________________ Date _______________________ Meet Director__________________________________________ Lifters Weight Class _________________ Actual Body Weight _________________________ Please Circle Correct Category(s) OPEN SUB-JUNIOR JUNIOR MASTER: I (40-49) II (50-59) III (men 60-69, women 60+) IV (70+) Please list ALL successful lifts including total, and Circle All Record Lifts Three Lift Contest First Attempt Second Attempt Third Attempt Squat ____________ kg Squat ____________ kg Squat ____________ kg Bench ____________ kg Bench ____________ kg Bench ____________ kg Dead ____________ kg Dead ____________ kg Dead ____________ kg Total ____________ kg Bench Only Contest Bench 1 __________ kg Bench 2 __________ kg Bench 3 ___________ kg IF POSSIBLE, ATTACH A COPY OF THE OFFICIAL RESULTS OF THE MEET SIGNED BY ALL REFEREES |