COMPETITOR
ENTRY FORM
SUNDAY 5TH MARCH
GRAND BALLROOM
COMPETITOR PERSONAL INFORMATION (Please PRINT clearly in BLOCK LETTERS)
SURNAME:
FIRST NAME:
EMAIL ADDRESS: DOB:
POSTAL ADDRESS:
MOBILE PHONE NUMBER:
All competitors must be registered with IFBB Australia.
To obtain your IFBB 1 year Membership Subscription please go to:
http://musclefitness.com.au/membership
COMPETITOR TRAINING INFORMATION
TRAINING GYM (NAME AND ADDRESS): IFBB MEMBERSHIP NUMBER or
Payment Receipt number
TRAINER/COACH:
NAME:
EMAIL:
MOBILE:
SHOW ONE / 9AM START
SHOW TWO / 4PM START
☐☐ TEENAGE 19 years and under
☐☐ JUNIOR 23 years and under
☐☐ NOVICE 1st timers
☐☐ MASTERS 40 years and over
☐☐ MASTERS 50 years and over
☐☐ OPEN 70kg and under
☐☐ OPEN 80kg and under
☐☐ OPEN 90kg and under
☐☐ OPEN 100kg and under
☐☐ OPEN Over 100kg
☐☐ CLASSIC Class I up to 168cm
☐☐ CLASSIC Class II 168cm -178cm
☐☐ CLASSIC Class III over 178cm
☐☐ FIGURE Novice
☐☐ FIGURE Intermediate
☐☐ FIGURE Masters 35 years and over
☐☐ FIGURE Open Short
☐☐ FIGURE Open Tall
☐☐ FITNESS Open
☐☐ BIKINI Junior 23 years and under
☐☐ BIKINI Novice Short
☐☐ BIKINI Novice Tall
☐☐ BIKINI Intermediate
☐☐ BIKINI Masters 35 years and over
☐☐ BIKINI Open Short
☐☐ BIKINI Open Tall
☐☐ PHYSIQUE Novice
☐☐ PHYSIQUE Open Short
☐☐ PHYSIQUE Open Tall
☐☐ BIKINI MODEL SEARCH
☐☐ PHYSIQUE Novice
☐☐ PHYSIQUE Open Short
☐☐ PHYSIQUE Open Tall
MEN
SELECT APPROPRIATE DIVISION
AGE:
WOMEN
WOMEN
Competitors Height & Weight:
***PLEASE NOTE***
MEN
cm
kg
All age divisions require photo ID.
Novice divisions are open to first time IFBB competitors only.
Intermediate divisions are open to competitors that have not placed top 3 in previous IFBB competition.
ENTRY FORM SUBMISSION
Entry forms must be submitted to IFBB WA either by email ([email protected]) or posted to
O’Mara Fitness; 4 Brown St, East Perth, WA 6004 by close of business, SUNDAY 26th FEBRUARY 2017.
Late submission will incur an admin fee. All enquiries please contact O’Mara Fitness on 08 9325 4397.
DIVISION DESCRIPTION
Competitors are required to aim to meet the ‘physique’ characteristics for the division they are entering,
as these are what judging is based on. PLEASE READ AND UNDERSTAND THE DIVISION DESCRIPTIONS.
COMPETITOR’S DECLARATION
I wish to enter the 2017 IFBB O’Mara Classic. I agree to pay $165.00 (GST included) for competition
registration fee and understand that this money is not refundable if I choose not to compete.
 I agree that the judge’s decision is final
 I agree to abide by the constitution of the IFBB International and also IFBB WA
 I give permission for any media, television or film coverage of my appearance in
relation to this event if such coverage has been approved by the Chief Executive
of IFBB WA
 I understand that my personal details may be used for marketing purposes by any
WA bodybuilding organisation or by any sponsor of the competition.
 I understand that Dream Tan & any similar bronzers that can be wiped off are banned from IFBB
competitions and I will not use these products.
I acknowledge and agree that during all such times as I am on the premises of this Centre and that
this function organized by the IFBB WA, inside or outside of the centre premises, that both my property
and my person shall be at my own risk in every respect and hereby disclaim and release the promoter
and every occupier thereof, all Competitors, volunteers and invitees to the full extent permitted by law
whether in contract or in tort, and whether arising out of any negligence by any person or otherwise,
and form all my liability of any kind which may arise in respect to any accidents or damage to
property or injury to any person on the Centre premise, or its surrounds. I hereby declare that the above
particulars are true and correct, and that I have read and understood these conditions.
Signature: _______________________________________ Date: ___________
PAYMENT SUMMARY
Registration Fee before sunday 26th FEBRUARY - $ 165.00 (GST included)
Registration Fee AFTER sunday 26th FEBRUARY - $ 215.00 (GST included)
$
ADDITIONAL DIVISION FEE (in same category only) $ 100.00
$
SHOW ONE / 9AM Tickets (10 seats per table)
Cash Payment $ 70.00
Qty ______ x $70.00
Credit Card or Eftpos $ 77.00
Qty ______ x $77.00
$
SHOW TWO / 4PM Tickets (10 seats per table)
OPTION 1 - GENERAL ADMISSION
Cash Payment $ 70.00
CC / Eftpos / Transfer $ 77.00
Qty ______ x $70.00
Qty ______ x $77.00
$
OPTION 2 - VIP HOSPITALITY TICKETS (Food & Drink Table Service)
Cash Payment $ 170.00
Qty ______ x $170.00
CC / Eftpos / Transfer $ 187.00
Qty ______ x $187.00
$
FRONT OF STAGE PHOTOS from AMPT Imaging -Early Bird Special
$ 99.00 for 1 division / $159 for 2 divisions (GST included)
$
TOTAL
PAYMENT OPTIONS
$
Please indicate chosen method & return form by email
to [email protected] or in person or by post to
O'Mara Fitness, 4 Brown St, East Perth, WA 6004
☐☐ Cash Payment at O’Mara Fitness 4 Brown St, East Perth
☐☐ Debit Card Payment at O’Mara Fitness 4 Brown St, East Perth
☐☐ Credit Card CC Number:
Cardholder’s Name:
Office use only
Payment received on _________________
Exp date:
/
CCV:
Signature (Printed Name if filling out digitally):
CASH
CREDIT
DEBIT CARD
Payment received by ____