Late Registration – Blue Collar Barbell: Long Island Powerlifting

Name *

Gender

Male
Female
Other

Equipment *

Raw (with sleeves or wraps)
Multi-Ply

Division *

Amateur
Professional
Police and Fire

Please see federation rules for further info. In general, if you have to ask, you belong in the Amateur division.

Sub-Division *

Based on age. You may enter multiple sub-divisions (ex: you may enter both "Open" and "Masters II" if you are 46 years of age). Entering multiple sub-divisions does NOT incur any additional fees.

Events & Entry Fees *

Full Power (squat + bench + deadlift) - $ 125.00
Push-Pull (bench + deadlift) - $ 100.00
Bench only - $ 80.00
Deadlift Only - $ 80.00

Choose which events to enter.

Birthdate *

Lifter's birthdate - format YYYY-MM-DD please!

Email *

For contact purposes - a copy of this registration form will be sent to you.

Phone *

Phone number for contact purposes.

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Total *

$ 0.00

Please take note of the above total as you will need it for the next step.