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2nd Annual Cancer's A Bench Charity Event
The 2nd Annual Cancer's A Bench will be on November 6th, at
The Gorilla Pit Elite
. This UPA Events Sanctioned event will be a Bench Only competition.
For weigh-ins, they are welcome to be the day prior to the competition. However lifters are allowed to do same-day weigh-ins. This event will start at 9:00 AM and weigh-ins will start at 7:30 AM on 11/6.
If you are not weighed in by 8:30 AM, you will not be allowed to lift
.
If you would like to weigh in the day prior, please call (309) 648-1268.
This is a chairity event for Cancer's A Bench Inc. (NFP).
Cancer's A Bench Inc (NFP) is a 501(c)3.
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Last Name
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Address 2
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Gender
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Preferred way to contact
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Phone
Email
Any
Weight Class (KG)
97
105
114
123
132
148
165
181
198
198+ Women's SHW
220
242
275
308
SHW
Competing Raw Or Equipped?
Raw
Equipped
Event Fee
Single Lifter [Shirt Included] ($50.00)
PayPal Fee Agreement
*
4%
Add an additional shirt?
Small ($20.00)
Medium ($20.00)
Large ($20.00)
XL ($20.00)
2 XL ($20.00)
3 XL ($20.00)
Release and Waiver
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I have volunteered to participate in a physical competition under the direction of the Cancer’s A Bench (CAB), which will include, but may not be limited to, weight and/or resistance training. In consideration of the CAB agreement to assist me, I do here and forever release and discharge and hereby hold harmless to Cancer’s A Bench, and their respective agents, heirs, assigns, contractors, and employees from any and all claims, demands, damages, rights of action or causes of action, present or future, arising out of or connected with my participation in this or any exercise program including any injuries resulting there from. THIS WAIVER AND RELEASE OF LIABILITY INCLUDES, WITHOUT LIMITATION, INJURIES WHICH MAY OCCUR AS A RESULT OF (1) EQUIPMENT THAT MAY MALFUNCTION OR BREAK (2) ANY SLIP, FALL, DROPPING OF EQUIPMENT AND (3) OUR NEGLIGENT INSTRUCTION OR SUPERVISION. I recognize that exercise might be difficult and strenuous and that there could be dangers inherent in exercise for some individuals. I acknowledge that the possibility of certain unusual physical changes during exercise does exist. These changes include abnormal blood pressure; fainting; disorders in heartbeat; heart attack; and, in rare instances, death. I understand that as a result of my participation, I could suffer an injury or physical disorder that could result in my becoming partially or totally disabled and incapable of performing any gainful employment or having a normal social life. I recognize that an examination by my physician must be obtained prior to involvement in this exercise program. I acknowledge and agree that I assume the risks associated with any and all activities and/or exercises in which I participate. I ACKNOWLEDGE THAT I HAVE THOROUGHLY READ THIS WAIVER AND RELEASE AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. BY SIGNING THIS DOCUMENT, I AM WAIVING ANY RIGHT I OR MY SUCCESSORS MIGHT HAVE TO BRING A LEGAL ACTION OR ASSERT A CLAIM AGAINST Cancer’s A Bench, or OTHERS REFERRED TO IN THIS DOCUMENT FOR ANY NEGLIGENCE OR THAT OF OUR EMPLOYEES, AGENTS, OR CONTRACTORS. I hereby give the CAB official professional recording company permission to videotape, photograph, and record my image and or likeness. I understand that such taping or recording may be used at the sole discretion of CAB. I also understand that giving permission is in no way an endorsement of CAB, or any product(s) distributed by CAB.
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Parent must sign if you are under 18 years of age
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