Post by cougarman on Apr 19, 2007 21:06:57 GMT
Please cut and paste onto a word doc fill in and return.
SEVERN VALLEY STRENGTH CHALLENGE NOVICE STRONGMAN SHOW
ENTERY FORM
Thank you for your interest in The Severn Valley Strongman/woman contest. Please complete and return with £10 entrance fee to: -
Whey Consortium Ltd
54 Church Drive
Quedgeley
Gloucester
GL2 4UW
Your Name
Your Address
Contact Number
E-mail Address
Age
Weight
Height
Maximum weights lifted raw
Dead lift
Squat
Overhead
Please compete your disclaimer and return with your entry form.
Name: Email address:
Phone Number:
Weight:
I accept the responsibility to ensure that I am medically and physically fit before
entering into competition. I also undertake to inspect equipment thoroughly to
satisfy myself that the equipment is safe and that the manner of my participation
does not involve personal risk.
VOLENTI NON FIT INJURIA. [Latin: no wrong is done to one who consents]
I understand and accept that the disciplines involve unusual trials of strength and
unusual demands on the human physique which make participation in the
disciplines especially hazardous and accordingly I agree that I am aware of the
risks and accept them and will personally bear all consequences of any injury
which I may sustain as a result of my participation in the disciplines including all
losses, costs and expenses which may be sustained by me as a result of any such
injury.
I hereby expressly release Mike Betty and Whey Consortium Ltd, your servants, agents, employees, contracts or
other persons and entities involved with the disciplines from any actions, claims
liabilities, losses, costs or expenses which might arise from such injury. I further understand that Mike Betty and Whey Consortium Ltd is not undertaking to provide the cost of any care or treatment that may be required in the event of injury and that, as between myself and Mike Betty and Whey Consortium Ltd, any insurance against the result of any such injury or disciplinary action is solely my responsibility.
Signed………………………………………………………………………….
Date:
Venue address.
Whitminster playing field.
School lane.
Whitminster.
Gloucester.
10 June 2007.
Start time TBA.
SEVERN VALLEY STRENGTH CHALLENGE NOVICE STRONGMAN SHOW
ENTERY FORM
Thank you for your interest in The Severn Valley Strongman/woman contest. Please complete and return with £10 entrance fee to: -
Whey Consortium Ltd
54 Church Drive
Quedgeley
Gloucester
GL2 4UW
Your Name
Your Address
Contact Number
E-mail Address
Age
Weight
Height
Maximum weights lifted raw
Dead lift
Squat
Overhead
Please compete your disclaimer and return with your entry form.
Name: Email address:
Phone Number:
Weight:
I accept the responsibility to ensure that I am medically and physically fit before
entering into competition. I also undertake to inspect equipment thoroughly to
satisfy myself that the equipment is safe and that the manner of my participation
does not involve personal risk.
VOLENTI NON FIT INJURIA. [Latin: no wrong is done to one who consents]
I understand and accept that the disciplines involve unusual trials of strength and
unusual demands on the human physique which make participation in the
disciplines especially hazardous and accordingly I agree that I am aware of the
risks and accept them and will personally bear all consequences of any injury
which I may sustain as a result of my participation in the disciplines including all
losses, costs and expenses which may be sustained by me as a result of any such
injury.
I hereby expressly release Mike Betty and Whey Consortium Ltd, your servants, agents, employees, contracts or
other persons and entities involved with the disciplines from any actions, claims
liabilities, losses, costs or expenses which might arise from such injury. I further understand that Mike Betty and Whey Consortium Ltd is not undertaking to provide the cost of any care or treatment that may be required in the event of injury and that, as between myself and Mike Betty and Whey Consortium Ltd, any insurance against the result of any such injury or disciplinary action is solely my responsibility.
Signed………………………………………………………………………….
Date:
Venue address.
Whitminster playing field.
School lane.
Whitminster.
Gloucester.
10 June 2007.
Start time TBA.
