Record Application

Lifter Information

Name:
Email:
Gender:
Province:
Birthdate:
Phone:
City:
Address:
Postal Code:
CPU Card #:

Meet Information

Contest:
Date Of Meet:
Bodyweight:
Division:
Location:
Meet Director:
Weightclass:

Indicate the Age Group(s) these record(s) applies to:

Powerlifting Record Lifts(Please list only Record Lifts)

Squat:
Bench:
Deadlift:
Total:

Bench Only Records

Bench Only:

Comments