Sudbury Classic Championships 2012 Competitor Entry
Form
Provincial Qualifier
Competitor Entry Form
Competitor
name:
Home address:
Address:___________________________________
City:______________________________________
Province:___________________________________
Postal Code:________________________________
Phone number:
Home:_____________________________________
Business:__________________________________________
E-mail:
OPA #
Sudbury Championships 2012 Page 1 Please check off the class(s) in which you are entering:
Note that if you are entering more than one class a complete entry form must be
submitted for each class. In addition the $80.00 entry fee applies to each class
that you are entering.
Select Your Competition Class by placing and X next to the appropriate row.
Men’s Bodybuilding
Junior Men (up to 23 years of age)
Masters Men (age 40 and over)
Lightweight Men (up to 165lbs)
Light Middleweight Men (over 165lbs to 176lbs)
Middleweight Men (over 176lbs to 187lbs)
Light Heavyweight Men (over 187 to 198lbs)
Heavyweight Men (over 198lbs - 220lbs)
Super Heavyweight Men (over 220lbs)
Women’s Bodybuilding
Junior Women (under 21 years)
Masters Women (age 35 and over)
Lightweight Women (up to 121lbs)
Heavyweight Women (over 121lbs)
Fitness
Fitness Short Women (up to and including 164 cm)
Fitness Tall Women (over 164 cm)
Figure
Figure Grandmaster Class (45 and over)
Figure Masters Women Short ( up to 5’4”age 35 and over)
Figure Masters Women Tall (over 5’4”age 35 and over)es Fitness
Figure Short Women (up to and including 158 cm)
Sudbury Championships 2012 Page 2 Figure Medium Women (up to and including 163 cm)
Figure Medium-Tall Women (up to and including 168 cm)
Figure Tall Women (over 168 cm)Women’s Fitness
Bikini
Bikini Up To And Including 5'4"
Bikini OVER 5'4"
Bikini Masters (age 35 and over)
Women’s Physique
Women’s Physique (up to and including 5’5”)
Women’s Physique (over 5’5”)
Men’s Physique
Men’s Physique (up to including 5’8”)
Men’s Physique (over 5’8”)
Entry fee of $ 80.00 per category _____________ (money order only). Registration
fee(s) must be paid in full prior to May 10th, 2012; all entry fees after this date will be
subjected to a $20.00 late fee. Fees are non-refundable.
OPA membership #:__________ (competitors must have this number prior to the event)
Membership can be obtained @ the Ontario Physique Association web site
www.physiqueassociation.ca
Please make money orders payable to Kieran Foley and send to: Kieran Foley @ 70
Laurentian Dr. Sault Ste Marie, Ontario, P6B 4G4
In consideration of your acceptance of this entry and fee, I waive and release all rights
and claims for damages against the Ontario Physique Association, Two Bros.
Productions. Two Bros. Productions and their associates, officials, agents, and
employees, or assign by reason of injury or damages which may occur while traveling to
or from or participating in this contest. I have read and understand all information on this
page. I further agree to abide by the decisions of the Ontario Physique Association and
respective judges. I declare that all information contained herein is, the best of my
knowledge, true, correct, and complete.
Sudbury Championships 2012 Page 3 NOTICE: NO REFUNDS ON ACCEPTED APPLICATIONS. THERE WILL ONLY BE
REFUNDS ON DENIED APPLICATIONS
Signature __________________________________ Date _________
Guardian (if under the age of 18) ______________________________ (signature)
______________________________ (print)
__________________________________ (date)
Sudbury Championships 2012 Page 4