competitor information natural michigan gladiator ... · replaced with housemusic. all competitors...

April 7th, 2018 - National qualifier- Ypsilanti, MI

COMPETITOR INFORMATION

Natural Michigan Gladiator Championships

SANCTION # 14439

PRODUCED BY: Full Circle productions • 44125 w. 12 mile rd E118, novi, mi 48377. For additional ticket, entry, or other information text 734-730-0351 or e-mail Remi bruyninga at [email protected] & Visit www.powerhousegym.com/events

CONTEST VENUE: Lincoln High school • 7425 willis rd, ypsilanti, mi 48197

DIVISIONS & CLASSES: all classes / divisions listed on entry form.

ELIGIBILITY, RESIDENCY AND AGE REQUIREMENTS: The Natural Michigan Gladiator championships is open to any U.S. athlete regardless of state of residency. All competitors must have a current NPC card, proof of age (copy of birth certificate or Driver’s License) evidencing that they will be of eligible age on the day of the event and residency (Driver’s License). A “True Novice” is an athlete that has never entered an NPC event. A “Novice” is any athlete that has not placed first in NPC show or top 10 in any national event. Purchase NPC card online at www.npcnewsonline.com click on “join NPC now” which is at the top on black bar. NPC cards will be available at check-in for $125 (do NOT mail it in with your entry form). Please bring a $125 check or money order only (CASH WILL NOT BE ACCEPTED) made payable to “NPC of the USA”.

DATE/SCHEDULE OF EVENTS: Friday, april 6th, 2018: MANDITORY CHECK IN 4:00-7:00 p.m. at elite fit center • 317 Industrial Park Dr, Belleville, MI 48111. Posing/ swimsuits suits must be worn at weigh-in and are subject to approval by the Head Judge. Competitors must also bring their photo ID and posing tapes/CDs. Due to liability issues, we are unable to provide warm-up equipment for competitors backstage. You are welcome, of course, to bring your own resistance bands, a towel, etc. (no Weights) Saturday, april 7th, 2018 a 9:00 A.M. Athlete meeting in the lincoln high school. All athletes must be present at and on time for the mandatory meeting. There will be NO ENTRIES accepted on april 7th, 2018.9:00 A.M.: Box Office Opens, 10:30 A.M.: Prejudging Begins4:00 P.M.: All Competitors Return/Box Office Opens/Doors Open to the Public4:30 P.M.: Competitor Check-In Backstage (ALL COMPETITORS) 5:00 P.M.: Finals Begin

AWARDS: Awards will be presented to the top 5 in each class and a custom lifting belt to the overall winners.

MUSIC AND ROUTINES: Bodybuilders and Fitness must submit their single song on a CD with your name clearly marked on the CD. Music will be collected at Check-In. Music with obscene/vulgar lyrics or not compatible with CD player will be replaced with housemusic. All competitors will perform their routines to music during the Finals. There is a 60-second time limit at the Finals for Bodybuilding and Women’s Physique, 2 minutes for Fitness competitors.

Host Hotel: Holiday Inn Express & Suites Belleville: (734) 857-6200 Mention Michigan Gladiator Championship for Discount!

TICKET INFO: 10:30 A.M. Prejudging: $305:00 P.M. Finals: $40 VIP (lower bowl) or $30 (Upper bowl). Tickets are on sale now. Finals tickets are reserved and sold first- come, first-served. Advanced purchases are strongly advised. Tickets can be purchased in advance by visiting www.powerhousegym.com/events.



April 7th, 2018 - National qualifier- Ypsilanti, MISUITS, TANNING PRODUCTS, & POSING OILTanning products cannot be applied in the theater and are subject to confiscation. All tanning products must be applied prior to the start of Check-In—NO EXCEPTIONS! Competitors will be responsible for payment for any stains or damage caused by tanning products or posing oil. Oil with “glitter” is not allowed. Eclipse tanning is the Michigan NPC exclusive Tanning sponsor and the only tanning company allowed back stage. To schedule a tanning appointment call: 231-499-9767 or eclypsetanning.com

DIVISION RULES & REGULATIONS/POSESPlease refer to the Rules & Regulations page on www.NPCNewsOnline.com.

Back Stage Passes:There is plenty of help back stage in the pump up area to assist ALL ATHLETES with their oil and bikini bite application. However, backstage VIP bracelets for coaches can be purchased for $40, a ticket to pre-judging / finals would still be required to be purchased for access. In addition, coaches must be current NPC card holders. Thank you in advance for your cooperation with this.

ENTRY FEES AND DEADLINESEarly entry, postmarked by april 1st, 2018 is $125 (make entry fee payable to full circle) Entry includes access to photos provided by Stage Time Photography. Early entrants may crossover and compete in another division (i.e. Masters to Open, Figure to Fitness, etc.) for an additional $80 each. Bodybuilding-to-Fitness/Figure/ Bikini/Physique and Bikini-to-Fitness/Figure crossovers are not allowed. Entry fee for entries submitted after the april 1st, 2018 postmark due date but prior to the day of the show is $175 and the crossover fees are an additional $80 each. There are NO ENTRIES accepted on day of show (april 7th, 2018). Although advanced registration is preferred, competitors will be allowed to register LATE at check-in on Friday april 6th, 2018, at the mandatory 4:00-7:00 check-in. confirmation of entry is your payment reciept from paypal.

April 7th, 2018 - National qualifier- Ypsilanti, MI



SANCTION # 14439

INSTRUCTIONS: Fill in all info above & check up to three classes below (where eligible). Be sure to include payment (details below). Additional info at www.powerhousegym.com/events

In consideration of being allowed to participate in any way in the 2015 NPC Bev Francis Atlantic States Championships (“Event”) promoted by Muscle Best, Inc.(“Promoter”) and sanctioned by the National Physique Committee of the USA, Inc. (“NPC”), its related events and activities, I, Please print name_____________________________________________________), the undersigned, acknowledge, appreciate and agree that: The risk of injury from the activities involved in this Event is signi�cant, including the potential for permanent paralysis and death, and while particular skills, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE PROMOTER AND/OR THE NPC or others, and assume full responsibility for my participation; and, I willingly agree to comply with the stated and customary terms and conditions for participation, if, however, I observe any unusual signi�cant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the Promoter immediately; and,I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS THE Promoter and the NPC and each of their o�cers, o�cials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used for the activity (“Releasees”), WITH RESPECT TO ANY AND ALL INJURY DISABILITY, DEATH, or loss or damage to person or property associated with my presence at or participation in or in traveling to and from the Event, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

The undersigned further consents and agrees that the undersigned will comply with all rules and regulations of the (“Hotel”) including any rules or regulations prohibiting cooking or food preparation in the hotel rooms. The undersigned further agrees that the undersigned will indemnify and hold harmless the NPC and the Promoter from and against any damages caused by the undersigned to the Hotel 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 rule or regulation of the Hotel 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. And in further consideration of permission being granted to me to participate in the Event and its related events. I hereby grant the NPC, Promoter and/or any other NPC-approved video or entertainment organization and all of their agents, successors, licensees and assigns, the right to photograph or otherwise reproduce (whether by �lm, tape, still photography or otherwise) my voice, appearance and name, and to exhibit, distribute, transmit, and/or otherwise exploit any and all media, including without limitation, by means of still photography, motion pictures, radio, television, television motion pictures, video, printing on digital or any other medium now known or hereafter devised, including with respect also to any merchandising, advertising and/or publicity, and the right to use my name and information about me in any connection with any of the foregoing. The rights granted by me hereunder are granted for the entire universe and shall endure in perpetuity and no further compensation shall be payable to me at any time in connection therewith. Nothing contained herein shall be deemed to obligate the NPC, Promoter, and/or any other NPC-approved video or entertainment organization, to photograph or otherwise reproduce my voice, appearance or name, or to make use of any rights granted herein. I also understand that the aforementioned rights may be reassigned at any time without further consent. I understand that the NPC, the Promoter and/or any NPC-approved video or entertainment organization, are videotaping and photographing the Event in express reliance upon the foregoing, and I represent and agree that I am free to grant the rights granted to the NPC, Promoter and/or any other NPC-approved video or entertainment organization hereunder. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVE UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARI-LY WITHOUT ANY INDUCEMENT.

X____________________________________________________________ Age:__________Date Signed:___________________________________

PARTICIPANT’S SIGNATURE

FOR PARENTS/GUARDIANS OF PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT TIME OF REGISTRATION)

This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releasees, and, for myself, my child and our heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child’s involvement or participation in these programs as provided above, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law.

X_____________________________________________________________ Age:________ Date Signed:_____________________________________

PARENT/LEGAL GUARDIAN’S SIGNATURE

NAME:

ADDRESS: STATE: ZIP:

PHONE:

CITY:

EMAIL:

AGE:

WEIGHT:

OFFICIAL USE ONLY

HEIGHT:

LOCATION: ATHLETE SCHEDULE:Mason Hall @ Baruch College17 Lexington AvenueNew York, NY 10010

- Check-In: 6:45AM-9:00AM- Athlete-only Meeting: 9:30AM*- Pre-Judging: 10:30AM*- Finals: 6:00PM*

*All events on June 6

MAIL FORM:

CONTACT US: [email protected] / 516-933-1111

ELIGIBILITY: SANCTIONED by the National Physique Committee of the USA

Open to all amateur athletes holding a valid 2015NPC membership (available to purchase at show). > Teen & Masters must have proof of age.Bev Francis Powerhouse Gym

235-C Robbins LaneSyosset, NY 11791

*NOVICE ELIGIBILITY: You have never placed firstin any class of any NPC contest.

WOMEN’S PHYSIQUE

OPEN (6 height classes)

NOVICE* (height classes TBD †)

MASTERS OVER 35 (height classes TBD †)

JUNIOR (age 23 & under) (one class)

OPEN (one class)

MASTERS OVER-35 (one class)

BIKINI

TEEN A (ages 13-16) (one class)

MASTERS OVER 35 (one class)

TEEN B (ages 17-19) (one class)

FIGUREOPEN (6 height classes)





MEN’S BODYBUILDING MEN’S PHYSIQUEOPEN (6 weight classes)

NOVICE* (4 weight classes)


WOMEN’S BODYBUILDINGOPEN (2 weight classes)

OPEN (one class)






TEEN (ages 13-19) (one class)


FITNESSMASTERS OVER 35 (one class)†Height classes will be determined by # of entries.

JUNIOR (age 23 & under) (one class)JUNIOR (age 23 & under) (one class)

INSTRUCTIONS: Fill in all info above & check up to three classes below (where eligible). Be sure to include payment (details below). Additional info at www.npcnortheast.com

NPC BEV FRANCISATLANTIC STATES CHAMPIONSHIPS

JUNE 6, 2015 · NATIONAL QUALIFIER · NEW YORK, NY

COMPETITOR ENTRY FORM

PAID:NPC#

ENTRY FEE: 1 Class $120 2 Classes=$170 3 Classes=$220 FOR OFFICLAL USE}TO ENTER: Mail this form and a Money order payable to Full Circle to the address above}}ENTRY DEADLINE: OCTOBER 17, 2015 / Late entries (including day of show) requires $75 LATE FEE

ENTER ONLINE & PURCHASE TICKETS - WWW.POWERHOUSEGYM.COM/EVENTS

In consideration of being allowed to participate in any way in the 2018 NPC Natural Michigan Gladiator Championships (“Event”) promoted by FULL CIRCLE. (“Promoter”) and sanctioned by the National Phy-sique Committee of the USA, Inc. (“NPC”), its related events and activities, I, Please print name_____________________________________________________), the undersigned, acknowledge, appreciate and agree that: The risk of injury from the activities involved in this Event is signicant, including the potential for permanent paralysis and death, and while particular skills, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE PROMOTER AND/OR THE NPC or others, and assume full responsibility for my participation; and, I willingly agree to comply with the stated and customary terms and conditions for participation, if, however, I observe any unusual signicant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the Promoter immediately; and,I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS THE Promoter and the NPC and each of their ocers, ocials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used for the activity (“Releasees”), WITH RESPECT TO ANY AND ALL INJURY DISABILITY, DEATH, or loss or damage to person or property associated with my presence at or participation in or in traveling to and from the Event, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

The undersigned further consents and agrees that the undersigned will comply with all rules and regulations of the (“Hotel”) including any rules or regulations prohibiting cooking or food preparation in the hotel rooms. The undersigned further agrees that the undersigned will indemnify and hold harmless the NPC and the Promoter from and against any damages caused by the undersigned to the Hotel 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 rule or regulation of the Hotel 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. And in further consideration of permission being granted to me to participate in the Event and its related events. I hereby grant the NPC, Promoter and/or any other NPC-approved video or entertainment organization and all of their agents, successors, licensees and assigns, the right to photograph or otherwise reproduce (whether by lm, tape, still photography or otherwise) my voice, appearance and name, and to exhibit, distribute, transmit, and/or otherwise exploit any and all media, including without limitation, by means of still photography, motion pictures, radio, television, television motion pictures, video, printing on digital or any other medium now known or hereafter devised, including with respect also to any merchandising, advertising and/or publicity, and the right to use my name and information about me in any connection with any of the foregoing. The rights granted by me hereunder are granted for the entire universe and shall endure in perpetuity and no further compensation shall be payable to me at any time in connection therewith. Nothing contained herein shall be deemed to obligate the NPC, Promoter, and/or any other NPC-approved video or entertainment organization, to photograph or otherwise reproduce my voice, appearance or name, or to make use of any rights granted herein. I also understand that the aforementioned rights may be reassigned at any time without further consent. I understand that the NPC, the Promoter and/or any NPC-ap-proved video or entertainment organization, are videotaping and photographing the Event in express reliance upon the foregoing, and I represent and agree that I am free to grant the rights granted to the NPC, Promoter and/or any other NPC-approved video or entertainment organization hereunder. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVE UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

X____________________________________________________________ Age:__________Date Signed:___________________________________PARTICIPANT’S SIGNATUREFOR PARENTS/GUARDIANS OF PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT TIME OF REGISTRATION)This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releasees, and, for myself, my child and our heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child’s involvement or participation in these programs as provided above, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law.

X_____________________________________________________________ Age:________ Date Signed:_____________________________________PARENT/LEGAL GUARDIAN’S SIGNATURE

October 21st • national qualifier • ypsilanti, mi


Central stateschampionships

SANCTION #14445

INSTRUCTIONS: Fill in all info above & check up to three classes below (where eligible). Be sure to include payment (details below). Additional info at www.powerhousegym.com/events

In consideration of being allowed to participate in any way in the 2015 NPC Bev Francis Atlantic States Championships (“Event”) promoted by Muscle Best, Inc.(“Promoter”) and sanctioned by the National Physique Committee of the USA, Inc. (“NPC”), its related events and activities, I, Please print name_____________________________________________________), the undersigned, acknowledge, appreciate and agree that: The risk of injury from the activities involved in this Event is signi�cant, including the potential for permanent paralysis and death, and while particular skills, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE PROMOTER AND/OR THE NPC or others, and assume full responsibility for my participation; and, I willingly agree to comply with the stated and customary terms and conditions for participation, if, however, I observe any unusual signi�cant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the Promoter immediately; and,I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS THE Promoter and the NPC and each of their o�cers, o�cials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used for the activity (“Releasees”), WITH RESPECT TO ANY AND ALL INJURY DISABILITY, DEATH, or loss or damage to person or property associated with my presence at or participation in or in traveling to and from the Event, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

The undersigned further consents and agrees that the undersigned will comply with all rules and regulations of the (“Hotel”) including any rules or regulations prohibiting cooking or food preparation in the hotel rooms. The undersigned further agrees that the undersigned will indemnify and hold harmless the NPC and the Promoter from and against any damages caused by the undersigned to the Hotel 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 rule or regulation of the Hotel 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. And in further consideration of permission being granted to me to participate in the Event and its related events. I hereby grant the NPC, Promoter and/or any other NPC-approved video or entertainment organization and all of their agents, successors, licensees and assigns, the right to photograph or otherwise reproduce (whether by �lm, tape, still photography or otherwise) my voice, appearance and name, and to exhibit, distribute, transmit, and/or otherwise exploit any and all media, including without limitation, by means of still photography, motion pictures, radio, television, television motion pictures, video, printing on digital or any other medium now known or hereafter devised, including with respect also to any merchandising, advertising and/or publicity, and the right to use my name and information about me in any connection with any of the foregoing. The rights granted by me hereunder are granted for the entire universe and shall endure in perpetuity and no further compensation shall be payable to me at any time in connection therewith. Nothing contained herein shall be deemed to obligate the NPC, Promoter, and/or any other NPC-approved video or entertainment organization, to photograph or otherwise reproduce my voice, appearance or name, or to make use of any rights granted herein. I also understand that the aforementioned rights may be reassigned at any time without further consent. I understand that the NPC, the Promoter and/or any NPC-approved video or entertainment organization, are videotaping and photographing the Event in express reliance upon the foregoing, and I represent and agree that I am free to grant the rights granted to the NPC, Promoter and/or any other NPC-approved video or entertainment organization hereunder. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVE UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARI-LY WITHOUT ANY INDUCEMENT.

X____________________________________________________________ Age:__________Date Signed:___________________________________

PARTICIPANT’S SIGNATURE

FOR PARENTS/GUARDIANS OF PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT TIME OF REGISTRATION)

This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releasees, and, for myself, my child and our heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child’s involvement or participation in these programs as provided above, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law.

X_____________________________________________________________ Age:________ Date Signed:_____________________________________

PARENT/LEGAL GUARDIAN’S SIGNATURE

NAME:

ADDRESS: STATE: ZIP:

PHONE:

CITY:

EMAIL:

AGE:

WEIGHT:

OFFICIAL USE ONLY

HEIGHT:

LOCATION: ATHLETE SCHEDULE:Mason Hall @ Baruch College17 Lexington AvenueNew York, NY 10010

- Check-In: 6:45AM-9:00AM- Athlete-only Meeting: 9:30AM*- Pre-Judging: 10:30AM*- Finals: 6:00PM*

*All events on June 6

MAIL FORM:

CONTACT US: [email protected] / 516-933-1111

ELIGIBILITY: SANCTIONED by the National Physique Committee of the USA

Open to all amateur athletes holding a valid 2015NPC membership (available to purchase at show). > Teen & Masters must have proof of age.Bev Francis Powerhouse Gym

235-C Robbins LaneSyosset, NY 11791

*NOVICE ELIGIBILITY: You have never placed firstin any class of any NPC contest.

WOMEN’S PHYSIQUE





OPEN (one class)

MASTERS OVER-35 (one class)

BIKINI

TEEN A (ages 13-16) (one class)


TEEN B (ages 17-19) (one class)

FIGUREOPEN (6 height classes)





MEN’S BODYBUILDING MEN’S PHYSIQUEOPEN (6 weight classes)

NOVICE* (4 weight classes)


WOMEN’S BODYBUILDINGOPEN (2 weight classes)

OPEN (one class)






TEEN (ages 13-19) (one class)


FITNESSMASTERS OVER 35 (one class)†Height classes will be determined by # of entries.

JUNIOR (age 23 & under) (one class)JUNIOR (age 23 & under) (one class)

INSTRUCTIONS: Fill in all info above & check up to three classes below (where eligible). Be sure to include payment (details below). Additional info at www.npcnortheast.com

NPC BEV FRANCISATLANTIC STATES CHAMPIONSHIPS

JUNE 6, 2015 · NATIONAL QUALIFIER · NEW YORK, NY

COMPETITOR ENTRY FORM

PAID:NPC#

ENTRY FEE: 1 Class $120 2 Classes=$170 3 Classes=$220 FOR OFFICLAL USE}TO ENTER: Mail this form and a Money order payable to Full Circle to the address above}}ENTRY DEADLINE: OCTOBER 17, 2015 / Late entries (including day of show) requires $75 LATE FEE

ENTER ONLINE & PURCHASE TICKETS - WWW.POWERHOUSEGYM.COM/EVENTS

In consideration of being allowed to participate in any way in the 2017 NPC Central States (“Event”) promoted by FULL CIRCLE. (“Promoter”) and sanctioned by the National Physique Committee of the USA, Inc. (“NPC”), its related events and activities, I, Please print name_____________________________________________________), the undersigned, acknowledge, appreciate and agree that: The risk of injury from the activities involved in this Event is signicant, including the potential for permanent paralysis and death, and while particular skills, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE PROMOTER AND/OR THE NPC or others, and assume full responsibility for my participation; and, I willingly agree to comply with the stated and customary terms and conditions for participation, if, however, I observe any unusual signicant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the Promoter immediately; and,I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS THE Promoter and the NPC and each of their ocers, ocials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used for the activity (“Releasees”), WITH RESPECT TO ANY AND ALL INJURY DISABILITY, DEATH, or loss or damage to person or property associated with my presence at or participation in or in traveling to and from the Event, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

The undersigned further consents and agrees that the undersigned will comply with all rules and regulations of the (“Hotel”) including any rules or regulations prohibiting cooking or food preparation in the hotel rooms. The undersigned further agrees that the undersigned will indemnify and hold harmless the NPC and the Promoter from and against any damages caused by the undersigned to the Hotel 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 rule or regulation of the Hotel 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. And in further consideration of permission being granted to me to participate in the Event and its related events. I hereby grant the NPC, Promoter and/or any other NPC-approved video or entertainment organization and all of their agents, successors, licensees and assigns, the right to photograph or otherwise reproduce (whether by lm, tape, still photography or otherwise) my voice, appearance and name, and to exhibit, distribute, transmit, and/or otherwise exploit any and all media, including without limitation, by means of still photography, motion pictures, radio, television, television motion pictures, video, printing on digital or any other medium now known or hereafter devised, including with respect also to any merchandising, advertising and/or publicity, and the right to use my name and information about me in any connection with any of the foregoing. The rights granted by me hereunder are granted for the entire universe and shall endure in perpetuity and no further compensation shall be payable to me at any time in connection therewith. Nothing contained herein shall be deemed to obligate the NPC, Promoter, and/or any other NPC-approved video or entertainment organization, to photograph or otherwise reproduce my voice, appearance or name, or to make use of any rights granted herein. I also understand that the aforementioned rights may be reassigned at any time without further consent. I understand that the NPC, the Promoter and/or any NPC-approved video or entertainment organization, are videotaping and photographing the Event in express reliance upon the foregoing, and I represent and agree that I am free to grant the rights granted to the NPC, Promoter and/or any other NPC-approved video or entertainment organization hereunder. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVE UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

X____________________________________________________________ Age:__________Date Signed:___________________________________PARTICIPANT’S SIGNATUREFOR PARENTS/GUARDIANS OF PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT TIME OF REGISTRATION)This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releasees, and, for myself, my child and our heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child’s involvement or participation in these programs as provided above, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law.

X_____________________________________________________________ Age:________ Date Signed:_____________________________________PARENT/LEGAL GUARDIAN’S SIGNATURE

ENTRY FEE: [ ] 1 CLASS $125 [ ] 2 CLASSES $205 [ ] 3 CLASSES $285 [ ] 4 CLASSES $365>TO ENTER: MAIL THIS FORM & MONEY ORDER PAYABLE TO FULL CIRCLE TO THE ADDRESS BELOW>>ENTRY DEADLINE: OCTOBER 14, 2017 - LATE ENTRIES REQUIRE $75 LATE FEE

MAIL TO: Full Circle 44125 W. 12 Mile Rd E118 Novi, MI 48377Tickets / Entry - www.powerhousegym.com/events

Bodybuilding Physique (Mens) Bikini FigureMen’s Open (7 Classes) Men’s Open (3 Classes) Open (3 Classes) Open (3 Classes)

Men’s Masters (40+) Men’s Masters (35+) Masters (35+) Masters (35+)

Men’s Grand Masters (50+) Men’s Grand Masters (45+) Grand Masters (45+) Grand Masters (45+)

Teen (16-19) Men’s Novice (2 Classes) Novice (2 Classes) Novice (2 Classes)

Men’s Wheelchair Men’s True Novice True Novice True Novice

Men’s Novice (3 Classes) Classic Open (3 Classes) Physique (Womens) Fitness (womens)Men’s True Novice Classic Masters (35+) Open (1 class) Open (1 Class)

Women’s open Classic GrandMasters (45+) Novice

Classic Novice

Classic True Novice

ENTRY FEE: [ ] 1 CLASS $125 [ ] 2 CLASSES $205 [ ] 3 CLASSES $285 [ ] 4 CLASSES $365>TO ENTER: MAIL THIS FORM & MONEY ORDER PAYABLE TO FULL CIRCLE TO THE ADDRESS BELOW>>ENTRY DEADLINE: APRIL 1ST, 2018 - LATE ENTRIES REQUIRE $75 LATE FEE

MAIL TO: Full Circle 44125 W. 12 Mile Rd E118 Novi, MI 48377Tickets / Entry - www.powerhousegym.com/events

competitor information natural michigan gladiator ... · replaced with housemusic. all competitors...

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