PEI Powerlifting
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Heather Ayles - 2014
Tilman Gallant - 2017
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Record Application
Lifter Information
Name:
Email:
Gender:
Male
Female
Province:
Birthdate:
Phone:
City:
Address:
Postal Code:
CPU Card #:
Meet Information
Contest:
Date Of Meet:
Bodyweight:
Division:
Equipped
Classic
Location:
Meet Director:
Weightclass:
30kg
35kg
40kg
44kg
43kg
48kg
47kg
52kg
57kg
63kg
69kg
76kg
84kg
84kg+
53kg
59kg
66kg
74kg
83kg
93kg
105kg
120kg
120kg+
Indicate the Age Group(s) these record(s) applies to:
Choose Correct Age Group
Youth 1
Youth 2
Youth 3
Sub-Junior
Junior
Open
Master 1
Master 2
Master 3
Master 4
Choose 1st Additional Age
Youth 1
Youth 2
Youth 3
Sub-Junior
Junior
Open
Master 1
Master 2
Master 3
Master 4
Choose 2nd Additional Age
Youth 1
Youth 2
Youth 3
Sub-Junior
Junior
Open
Master 1
Master 2
Master 3
Master 4
Powerlifting Record Lifts(Please list only Record Lifts)
Squat:
Bench:
Deadlift:
Total:
Bench Only Records
Bench Only:
Comments