2018 Larry Mintz Memorial
Date/Time:Saturday, June 01, 2019 (7:00 AM - 11:00 PM)
Organizer:LONG ISLAND WLC
Sanction #:  60-19-189956
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Meet Details
 
Meet Description

OFFICIAL ENTRY FORM 2019 LARRY MINTZ MEMORIAL WEIGHTLIFTING MEET SATURDAY, June 1, 2019 LOCATION: LOST BATTALION HALL, 93 –29 QUEENS BLVD,

About this Event

OFFICIAL ENTRY FORM

2019 LARRY MINTZ MEMORIAL WEIGHTLIFTING MEET

SATURDAY, June 1, 2019

LOCATION: LOST BATTALION HALL, 93 –29 QUEENS BLVD, REGO PARK, NEW YORK 11374

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RETURN ENTRY TO: Chris Smith

111 Division Avenue, Levittown, NY 11756

*Tel: 516-317-3436 – Email: longislandweightlifting@gmail.com

ENTRY FEES: $69.87 on Eventbrite and you must copy and passed the entry in to a word document and e mail it to longislandweightlifting@gmail.com as soon as you make payment or you will not be in the meet.Your event URL is https://www.eventbrite.com/e/2019-larry-mintz-memorial-tickets-57284609810

Or mail a Check or Money Order Payable to Chris Smith with the entry for $60.00. Please no certified mail.

ENTRY DEADLINE: Post-Marked NO LATER than, May 28. 2019.

*NOTE: LATE ENTRIES

** ELIGIBILTY: Competition is open to ALL registered USAW athletes.

*** DUE TO TIME RESTRAINTS, THERE IS A LIMIT OF 64 COMPETITORS {FIRST COME, FIRST SERVED} with 32 spots for males, 32 spots for females. Unclaimed registrations will be awarded after the entry deadline regardless of gender.

Men's weight classes 55,61,67,73,81,89,96,102,109,+109 kg

Female's weight classes 45,49,55,59,64,71,76,81,87,+87 kg

You must provide an entry total. Your entry total will determine what session you lift in. You will be assigned to an A or B session based on your entry total. Please check your e-mail starting on Tuesday, May 28, for your session assignment and any change in weigh in times.

Please enter me in the 2019 Larry Mintz Memorial Weightlifting Meet to be held on Saturday, June 1, 2019 at the Lost Battalion Hall (LBH). I certify that I am an amateur in good standing. In consideration of my entry in the competition, I do hereby waive and release the USA Weightlifting and the Metropolitan LWC, Local Organizing Committee, Lost Battalion Hall Weightlifting Team, NYC Department of Parks and Recreation, its directors, officers, and agents, the meet directors, competition personnel, volunteers, otherwise listed as the organizers, and all other related parties from any and all actions, liability, claim, and demands of every kind and nature that I or my heirs or personal representatives may have for bodily injury, for expenses of medical treatment, hospitalization and other costs, damages or losses suffered or incurred by me in connection with my travel to and from the meet and my participation in the competition and related activities: except that the foregoing waiver and release shall not apply to injuries, damages, and loss resulting from the gross negligence or intentional misconduct of USA Weightlifting or the Metropolitan LWC for bodily injuries or medical expenses covered by accidental death, dismemberment and/or loss of sight and medical reimbursement insurance policies maintained by USA Weightlifting.

I agree to be filmed and photographed under conditions approved and authorized by USA Weightlifting, the Metropolitan LWC, NYC Department of Parks and Recreation and the Lost Battalion Hall Weightlifting Team and its members to include the use of my name, biographical information, public appearances, interviews, photographs, portrait and motion pictures and television recordings of my weightlifting performance and grant to USA Weightlifting, the Metropolitan LWC, NYC Department of Parks and Recreation and the Lost Battalion Hall Weightlifting Team and its members the right to record and make use of the same, and to authorize others to do so in promoting the competition and the success of the weightlifting team on which I compete, to promote the image of the USA Weightlifting and its Metropolitan LWC, its sponsors and advertisers, and the sport of Olympic Weightlifting, and to fund the activities of the LBH Program.

I agree that the Organizers may make judgments with appropriate input from available medical personnel as to my treatment, hospitalization or other medical care in the event of my illness or accidental injury in connection with my participation in the competition should I be disabled or incompetent to make necessary and appropriate decisions concerning such treatment, hospitalization or other care. I authorize the USA Weightlifting, the Metropolitan LWC, and its agents (including competition personnel and volunteers) to make decisions for me as though they stood in a relationship to me of parent, guardian, or next of kin should circumstances require the aforementioned to make judgments provided that my next of kin cannot be timely and/or conveniently contacted to participate in the making of such judgments.

I hereby release and agree to hold the Organizers harmless from all expenses, causes of action, liability, claims and demands arising from good faith judgments made by the Organizers concerning my treatment, hospitalization and medical care in the event of my illness, injury or other emergency circumstances in connection with the competition.

I agree that I will be financially responsible for treatment, hospitalization and other medical care received by me in the event of my illness, injury or other emergency circumstances in connection with the competition, except to the extent of my injuries and medical expenses, if any, are covered by accidental death, dismemberment, loss of sight, and medical reimbursement insurance policies: in which event, I will nevertheless continue to be financially responsible for expenses of treatment, hospitalization and other medical care in excess of such policies’ limits.

 

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PLEASE TYPE OR PRINT ALL INFORMATION CLEARLY

WEIGHT CLASS (enter only one): ________ENTRY TOTAL: _____________ (required)

MALE: ____ FEMALE: _____AGE: as of 12/31/2019: ______DATE OF BIRTH:____________

NAME _________________________________2018 USAW REG #: ______

ADDRESS:________________________________________________________________

CITY: _________________________________ STATE: __________ ZIP: ________________

PHONE: (________) ______________ EMAIL ADDRESS:_________________________________

USAW CLUB AFFILIATION: ________________________________

Name of Coach___________________________________

 

I HAVE READ AND UNDERSTAND THE FOREGOING REQUEST AND RELEASE:

SIGNATURE: _________________________________________ DATE: _________

IF YOU ARE UNDER 18, YOUR PARENT OR GUARDIAN MUST SIGN BELOW.

SIGNATURE OF PARENT/GUARDIAN______________________DATE______________

AWARDS will be presented after all A sessions are done. Awards to TOP THREE PLACE WINNERS in each Weight-Class. Outstanding lifters for, Sr’s, Jr’s (Sinclair) and masters (Sinclair-Meltzer). Team award will be Male and Female Combined. Teams will be 5 men and 5 Female.

The competition secretary will be Jeff Scott. This meet will have many national ref or higher. If any issue arises please see the competition secretary or Assistant meet director Dena Smith

NOTE: The Competition Organizers Reserve The Right To Reject Any Entry And/Or Person To Participate In The Larry Mintz Memorial Weightlifting Meet.

For this event, “A” and “B” SESSIONS will be created.

Preliminary schedule:

Session WEIGH-IN COMPETITION

All B session males: 8:10 AM 10:10 AM

All A session males: 10:30 AM 12:30 PM

All B session females: 1:15 PM 3:15 PM

All A session females: 3:10 PM 5:10 PM

 

 

Location & Contact Information
Facility:Lost Battalion Hall
93-29 Queens Blvd
Rego Park, NY  11374
Coordinator:Dena Smith
Email:
Phone:(516)3171584
 
 

Last Updated: 12/7/2019 5:10:04 AM

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