Pump Off Team Registration

$200 Entry Fee (4-5 Members)

Name (of Captain)(Required)

First Last

You will be main Point of Contact. Please be sure all information is valid and correct

What is your team name?(Required)

Email (of Captain)(Required)

Phone (of Captain)(Required)

Gender(Required)

What would be Captain's weight class on show day?(Required)

This is to determine the weight you will use for the Arm Blaster Strict Curl

Captain Tshirt size (Adult size)(Required)

Upload picture of gym/facility/team logo

Accepted file types: jpeg, pdf, orpng, Max. file size: 10 MB.

This logo will be on our Pump Off tshirt. Please be sure it is of good quality (preferred 100kb or better). Needs to be in by 5/31 to be on the shirt

Name of player #2(Required)

What would be player #2 weight class on show day?(Required)

This is to determine the weight you will use for the Arm Blaster Strict Curl

Player #2 Tshirt size (Adult size)(Required)

Name of player #3(Required)

What would be player #3 weight class on show day?(Required)

This is to determine the weight you will use for the Arm Blaster Strict Curl

Player #3 Tshirt size (Adult size)(Required)

Name of player #4(Required)

What would be player #4 weight class on show day?(Required)

This is to determine the weight you will use for the Arm Blaster Strict Curl

Player #4 Tshirt size (Adult size)(Required)

Name of player #5

What would be player #5 weight class on show day?

This is to determine the weight you will use for the Arm Blaster Strict Curl

Player #5 Tshirt size (Adult size)

Team Registration fee(Required)

Price:

This team entry will give all team members a ticket to the NWANC, Pump Off event tshirt, stage posing picture, and a chance to win the $300 team award.

Waiver of Liability and Media Release:(Required)

I understand the Waiver and Media Release

In consideration of the acceptance of the entry, I waive for myself and my heirs and all claims for damages against Joe Wilson Productions (NWA Natural Championships), any of the beneficiaries of this event, the University of Arkansas, the Faulkner Performing Arts Center, the NANBF, sponsors of the Pump Off and their representatives, any Arkansas television or radio station, and officials and volunteers for injuries received during and as a result of this event. If I should suffer injury or illness, I authorize officials at the race to use their discretion to have me treated and be transported to a medical facility and I take full responsibility for this action. I certify that I am physically fit and sufficiently prepared myself for this event. Signature required for entry to be accepted. Parent’s signature is required if entrant is under 18 years old. MEDIA RELEASE: I hereby grant my permission to Joe Wilson Productions, the Facebook/Instagram page of the NWA Natural Championships, and any affiliates of the NWA Natural Championships for the free use of my name, photograph and video, in any media, print, broadcast, telecast, internet, web, or video account from the NWANC event.

Total

Payment Method(Required)

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name