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2012 Entry Form
GRANITE STATE
STRONGMAN/WOMAN
CHAMPIONSHIP 2012
SEACOAST HARLEY-DAVIDSON
17 LAFAYETTE ROAD (RTE.1)
NORTH HAMPTON, NH 03860
JULY 28, 2012
Platinum Level
New Hampshire State Championship
START TIME 10:30 am
Entry Form
Name: ____________________________________________________________________
Address: ______________________________________________________________________
City / State: ____________________________________________Zip:_________________
Phone: _________________________
E-mail_________________________________________
AAge: __________ Height: _________ Weight: _________
Please indicate Division: Heavyweight Amateur Men(232 above______ Middleweight(201-231)____ Lightweight Amateur Men(175/200) _____ Women(HW/LW)_______ Novice/crossfit Open _____ Masters Open ______
T-Shirt Size _____________
Most recent Accomplishments/Titles Held/Achievements in Strongman Events and other sports:
Please use reverse side or separate sheet of paper to list. This is very important for our sponsors and announcers!
In consideration of your acceptance of this entry, I hereby waive and release intending to be legally bound for myself, executors, administrators, and my heirs, all rights and claims for damages I may have against James Pierce, Robert Chaisson, City of North Hampton N.H., Seacoast Harley Davidson and it’s employees, North American Strongman Inc. Willie Or Dione Wessels, the sponsors, the officials, employees, representatives or assigns of any of the foregoing reasons of injury or damage I might incur while traveling to or from or participating in the competition.
I hereby grant NAS, and /or any approved video or entertainment organization and all of their agents, successors, licenses and assigns, the right to photograph or otherwise reproduce (whether by film, tape, still photography or otherwise) my voice, appearance and name, and to exhibit, distribute, transmit, and /or otherwise exploit any and all media, including without limitation, by means of still photography, motion picture, radio, television, television motion pictures, video, printing or any other medium now known or hereafter devised, including with respect also to any merchandising, advertising and/or publicity, and the right to us my name and information about me in any connection with any of the foregoing. The rights granted by me hereunder are granted for the entire universe and shall endure in perpetuity and no further compensation shall be payable to me at anytime in connection therewith. Nothing contained herein shall be deemed to obligate NAS, and/or any other approved video or entertainment organization, to photograph or otherwise reproduce my voice, appearance or name, or to make use of any rights granted herein. I also understand that the aforementioned rights may be reassigned at any time without further consent. I understand that NAS and/or any other approved video or entertainment organization are videotaping and photographing the event in express reliance upon the foregoing, and I represent and agree that I am free to grant the rights granted to NAS and/or any other approved video or entertainment organization hereunder.
There I affix my signature below. If under 18 legal guardian signature required.
Signature Required: ______________________
Guardian Signature :( If necessary) _________________
Entry Fee: $65.00 (A portion of each entry will be donated to the charities of this event)(If sent in before April 1,2012 $50.00, by April 15 2012 $60.00)
Make checks payable to: James Pierce (Granite State Strongman/woman Championship)
Mail Entry Fee and Form to
James Pierce
64 Newton Drive
Nashua, NH. 03063
Note: This is an NAS, Inc. sanctioned event. All participants must have an active NAS, Inc. card.
*** APPLICATION DEADLINE IS July 18,2012. 10 days PRIOR TO THE SHOW.
*** NO DAY OF CONTEST SIGN UPS WILL BE ALLOWED****
Description of Events
(Subject to Change!)
1) Viking Press event will be for reps.60 second time limit. Press above head with elbows locked. (MUST WAIT for DOWN Command and CONTROL Down or REP will NOT count)
Women: LW=100 HW = 150lbs
Novice/Cross fit: = 200lbs
Men: LW
175 = 220lbs
200 = 220lbs
231(Master) = 260lbs
HW 232 over = 300lbs
Additional classes will be added if 5 or more athletes compete 300lb-320lb , 301=350)
2) CAR DEADLIFT: Set up will be car DL platform
Women Open= little car
Novice/175, and 200lb class= bigger car
231/Master = bigger car with weight in trunk
265-300 = really big car
301+=650lbs (same as above if 5 or more athletes)
3) CRUCIFIX HOLD: hold matching large hammers at side palms must face forward and hammer head must stay between eyes and chin
Women: 15lb
Men
Novice,175, 200:25lb
231, Masters: 25bs
232 and above: 35lbs
4)VERMONSTER Truck Harness Pull: 50ft 60 seconds time limit with rope
Women:
Men:
Novice:
200:
230/Masters:
232 and above:
5) Medley: Yoke 40 ft, Blob (keg with no handles carry 40ft carried like hussafel stone, frame carry 40ft
Women/ LW-350 Y, 150 B, 250F// HW 400 Y, 200B,300 F
Men’s Novice/CF: 400Y, 200B, 300F
MEN
175, 200 class: 500 Y, 200B, 500 F
231, Master: 600 Y, 250 B, 550 F
232 and above:700 Y, 250 B, 600 f
ALL events and weight will be determined after testing
SUBJECT TO CHANGES
STRONGMAN/WOMAN
CHAMPIONSHIP 2012
SEACOAST HARLEY-DAVIDSON
17 LAFAYETTE ROAD (RTE.1)
NORTH HAMPTON, NH 03860
JULY 28, 2012
Platinum Level
New Hampshire State Championship
START TIME 10:30 am
Entry Form
Name: ____________________________________________________________________
Address: ______________________________________________________________________
City / State: ____________________________________________Zip:_________________
Phone: _________________________
E-mail_________________________________________
AAge: __________ Height: _________ Weight: _________
Please indicate Division: Heavyweight Amateur Men(232 above______ Middleweight(201-231)____ Lightweight Amateur Men(175/200) _____ Women(HW/LW)_______ Novice/crossfit Open _____ Masters Open ______
T-Shirt Size _____________
Most recent Accomplishments/Titles Held/Achievements in Strongman Events and other sports:
Please use reverse side or separate sheet of paper to list. This is very important for our sponsors and announcers!
In consideration of your acceptance of this entry, I hereby waive and release intending to be legally bound for myself, executors, administrators, and my heirs, all rights and claims for damages I may have against James Pierce, Robert Chaisson, City of North Hampton N.H., Seacoast Harley Davidson and it’s employees, North American Strongman Inc. Willie Or Dione Wessels, the sponsors, the officials, employees, representatives or assigns of any of the foregoing reasons of injury or damage I might incur while traveling to or from or participating in the competition.
I hereby grant NAS, and /or any approved video or entertainment organization and all of their agents, successors, licenses and assigns, the right to photograph or otherwise reproduce (whether by film, tape, still photography or otherwise) my voice, appearance and name, and to exhibit, distribute, transmit, and /or otherwise exploit any and all media, including without limitation, by means of still photography, motion picture, radio, television, television motion pictures, video, printing or any other medium now known or hereafter devised, including with respect also to any merchandising, advertising and/or publicity, and the right to us my name and information about me in any connection with any of the foregoing. The rights granted by me hereunder are granted for the entire universe and shall endure in perpetuity and no further compensation shall be payable to me at anytime in connection therewith. Nothing contained herein shall be deemed to obligate NAS, and/or any other approved video or entertainment organization, to photograph or otherwise reproduce my voice, appearance or name, or to make use of any rights granted herein. I also understand that the aforementioned rights may be reassigned at any time without further consent. I understand that NAS and/or any other approved video or entertainment organization are videotaping and photographing the event in express reliance upon the foregoing, and I represent and agree that I am free to grant the rights granted to NAS and/or any other approved video or entertainment organization hereunder.
There I affix my signature below. If under 18 legal guardian signature required.
Signature Required: ______________________
Guardian Signature :( If necessary) _________________
Entry Fee: $65.00 (A portion of each entry will be donated to the charities of this event)(If sent in before April 1,2012 $50.00, by April 15 2012 $60.00)
Make checks payable to: James Pierce (Granite State Strongman/woman Championship)
Mail Entry Fee and Form to
James Pierce
64 Newton Drive
Nashua, NH. 03063
Note: This is an NAS, Inc. sanctioned event. All participants must have an active NAS, Inc. card.
*** APPLICATION DEADLINE IS July 18,2012. 10 days PRIOR TO THE SHOW.
*** NO DAY OF CONTEST SIGN UPS WILL BE ALLOWED****
Description of Events
(Subject to Change!)
1) Viking Press event will be for reps.60 second time limit. Press above head with elbows locked. (MUST WAIT for DOWN Command and CONTROL Down or REP will NOT count)
Women: LW=100 HW = 150lbs
Novice/Cross fit: = 200lbs
Men: LW
175 = 220lbs
200 = 220lbs
231(Master) = 260lbs
HW 232 over = 300lbs
Additional classes will be added if 5 or more athletes compete 300lb-320lb , 301=350)
2) CAR DEADLIFT: Set up will be car DL platform
Women Open= little car
Novice/175, and 200lb class= bigger car
231/Master = bigger car with weight in trunk
265-300 = really big car
301+=650lbs (same as above if 5 or more athletes)
3) CRUCIFIX HOLD: hold matching large hammers at side palms must face forward and hammer head must stay between eyes and chin
Women: 15lb
Men
Novice,175, 200:25lb
231, Masters: 25bs
232 and above: 35lbs
4)VERMONSTER Truck Harness Pull: 50ft 60 seconds time limit with rope
Women:
Men:
Novice:
200:
230/Masters:
232 and above:
5) Medley: Yoke 40 ft, Blob (keg with no handles carry 40ft carried like hussafel stone, frame carry 40ft
Women/ LW-350 Y, 150 B, 250F// HW 400 Y, 200B,300 F
Men’s Novice/CF: 400Y, 200B, 300F
MEN
175, 200 class: 500 Y, 200B, 500 F
231, Master: 600 Y, 250 B, 550 F
232 and above:700 Y, 250 B, 600 f
ALL events and weight will be determined after testing
SUBJECT TO CHANGES
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