
2011 NPC SOUTHERN STATES BODYBUILDING,
FITNESS, FIGURE, BIKINI & MEN'S PHYSIQUE CHAMPIONSHIPS
OFFICIAL ENTRY FORM
SPECIAL NOTICE : This contest is an OFFICIAL NATIONAL QUALIFIER for the 2011 NPC Teen, Masters & Collegiate Nationals to be held July 22-23, 2011 in Pittsburgh, PA, the 2011 NPC USA to be held July 29-30, 2011 in Las Vegas, NV, and the Nov. 18-19, 2011 NPC Nationals in Miami Beach, FL. and all other National events for this year and 2012.
SANCTION : This contest is sanctioned by the National Physique Committee of the USA Inc. (NPC). Sanction #11372.
ELIGIBILITY : This contest is Open to all male and female athletes in the U.S. Contestants must be a member of the NPC and membership cards will be available for purchase at the event: 2011 fee: $100.00. In the Teen categories you must be 19 years of age or under as of the date of the contest. For the Masters Women & Men , athletes must be that age or older as of the date of the contest.
NEW - PREJUDGING FOR FITNESS, FIGURE, BIKINI, MEN’S FITNESS & MEN’S PHYSIQUE: To help make the evening show run more smoothly and in less time, a Prejudging will be held for the first time for these athletes starting at 10:00am on Friday, July 8th in the War Memorial Auditorium – see below for check in times..
NEW – CROSSOVERS: Bodybuilders will be allowed to enter one other contest in addition to their primary event –subject to their being qualified. Athletes may not enter more than one age group. Fitness, Figure, Bikini, Men's Fitness & Men's Physique will be able to crossover as well. No crossovers will be permitted between Fitness, Figure, Bikini & Bodybuilding.
NEW – MEN’S PHYSIQUE: For complete details, rules and regulations on MEN’S PHYSIQUE, refer to the NPC website (www.NPCnewsOnline.com,). There will be 2 classes and an overall.
HOTEL ACCOMMODATIONS : The official host hotel is the EMBASSY SUITES HOTEL-FORT LAUDERDALE, 1100 Southeast 17th Street, Ft. Lauderdale, FL 33316. Every room is a suite with a kitchen (fridge, microwave), dining area and sofa that pulls out for use as an additional bed plus complimentary cooked-to-order breakfast. A special discounted rate has been arranged. For reservations, call toll free 1-800-Embassy - be sure to mention that you are part of the SOUTHERN STATES CHAMPIONSHIPS. The local telephone for the hotel is 954-527-2700. Web site: www.ftlauderdale.embassysuites.com. For those staying at the host hotel, by signing this agreement, they agree to be responsible for any damage to the hotel room as a result of any body color, oils, spray tan or any other damage to hotel bedding, towels, carpet, drapes, walls, doors or any other hotel furnishings.
AWARDS: Impressive sculptures by Niels Andersen will be the awards. Every competitor will receive a FREE So. States t-shirt, Goody Bag and copy of the official souvenir program.
MEN'S SO. STATES : 5 Places in each of the 7 weight classes plus Overall. BONUS: The Overall winner will receive travel expense reimbursement of $250.00 good for the 2011 NPC USA or the 2011 NPC Nationals. |
TANNING: On-Site/Backstage Tanning will be provided by Hot Spot of Sarasota. Tanning will be available to the competitors on Thursday at the Embassy Suite Hotel (contest host hotel), and then , Friday and Saturday backstage at the War Memorial Auditorium. To make an appointment Call ALISA HOSTETTLER @ 727-403-5180 or e-mail @ Tan@HotSpotSarasota.com
WEIGH-INS/CHECK IN:
FITNESS, FIGURE, BIKINI, MEN’S FITNESS & MEN’S PHYSIQUE:
BODYBUILDING:
ENTRY FEE: $55.00. CROSSOVERS: Additional $30.00 for second contest. Make check or money order payable to: USA SPORTS PROMOTIONS OF FL INC. and send to: USA SPORTS PROMOTIONS OF FL. INC. 1126 SO. FEDERAL HWY. SUITE # 169 . FT. LAUDERDALE , FL 33316 TEL: 954-763-2718
DEADLINE: To be listed in the program, all entries must be received on or before June 28, 2011. Late entries accepted up to and on day of contest. $25.00 late fee.
PRINT, TEAR OFF & RETURN
| MEN’S OPEN SOUTHERN STATES ___Bantamweight Class (143 ¼ & under) ___Lightweight Class (Above 143 ¼ to 154 ¼) ___Welterweight Class(Above 154 ¼ to 165 ¼) ___Middleweight Class (Above 165¼ to 176 ¼) ___ Lightheavyweight Class (Above 176 ¼ to 198 ¼) ___ Heavyweight Class (Above 198 ¼ to 225 ¼) ___ Super Heavyweight Class (Above 225 ¼) WOMEN’S OPEN SOUTHERN STATES WOMEN’S MASTERS (OVER 30) SO. .STATES WOMEN’S MASTERS (OVER 40) SO. STATES WOMEN’S MASTERS (OVER 50) SO. STATES TEENAGE MEN’S SOUTHERN STATES MEN’S OVER 40 SOUTHERN STATES MEN’S OPEN FITNESS NEW - MEN’S PHYSIQUE |
MEN’S OVER 50 SOUTHERN STATES GRAND MASTERS (MEN OVER 70) SO. STATES WOMEN’S OPEN FITNESS SOUTHERN STATES TEEN WOMEN’S FITNESS SOUTHERN STATES WOMEN’S OPEN FIGURE SOUTHERN STATES TEEN WOMEN’S FIGURE SOUTHERN STATES MASTERS WOMEN OVER 30 FIGURE SO. STATES MASTERS WOMEN OVER 40 FIGURE SO. STATES MASTERS WOMEN OVER 50 FIGURE SO. STATES WOMEN'S OPEN BIKINI NEW – WOMEN’S OPEN BIKINI OVER 30 |
Note: All contestants will be officially checked in (see
times above) and should have their competition suits on or available for approval.
NAME: __________________________________
AGE: _____________
WEIGHT: ___________ HEIGHT: __________________
YEARS TRAINED:________________________
STREET ADDRESS: _______________________________________ APT. #: ________
CITY: _________________________ STATE: ___________________ ZIP: ___________________________
TELEPHONE (_____) _________________________________________
NPC CARD
#: _____________________________
OCCUPATION:______________________________________________
TEAM/CLUB/GYM AFFILIATION: _______________________________________________________
HOBBIES: __________________________________________________________________
PAST CONTESTS ENTERED & RESULTS: __________________________________________________
____________________________________________________________________________________
E-MAIL: _________________________________________________________________
In consideration of your accepting this entry, I, hereby intending to be legally bound for myself, my heirs, executors or administrators, waive any and all right and claim for damages I may have against the National Physique Committee of the USA Inc. (NPC), Peter W. Potter, USA Sports Promotions of FL Inc., Maria Bellando, Manuel Mair, War Memorial Auditorium, the sponsors and them or their agents, representatives and assignees for any and all injuries suffered by me at said NPC Southern States Championships and in travel to and from said contest. I hereby grant the NPC and/or any other NPC approved video or entertainment organization and all of their agents, successors, licensees 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 pictures, radio, television, 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 use my name and information about me in any connection with any of the foregoing.
SEND ALL ENTRIES & FEES TO:
USA SPORTS PROMOTIONS OF FL INC.
1126 SO. FEDERAL HWY., SUITE #169
FT. LAUDERDALE, FL 33316
SIGNATURE: _______________________________________________________
PARENT/GUARDIAN IF MINOR:_________________________________________
DATE: _______________