|
2013 MARIA BELLANDO NPC SOUTHERN STATES FITNESS, FIGURE & BIKINI CHAMPIONSHIPS OFFICIAL ENTRY FORM - WOMEN SANCTION : This competition is sanctioned by the National Physique Committee of the USA Inc. NPC Sanction #12028. ELIGIBILITY : This contest is open to all women in the U.S. Those in the Teenage & Masters Women must provide proof of age at the check in. Contestants must register to join the NPC (2013 fee is $100) and membership application cards will be available at the contest. The contest is a NATIONAL QUALIFIER for all events for this year and 2014. HOTEL ACCOMODATIONS : The official host hotel is the GALLERY ONE - FT LAUDERDALE DOUBLETREE SUITES HOTEL, 2670 E.Sunrise Blvd., Ft. Lauderdale, FL 33304... The hotel is located near the contest site. Every room is a suite with a kitchen (fridge, microwave), dining area and living room.. A special discounted rate has been arranged. For reservations, call toll free 1-954-565-3800 -be sure to mention that you are part of the SOUTHERN STATES CHAMPIONSHIP in order to get the discounted rate. Reservations can also be made by going to www.npcsouthernstates.com and clicking of the “HOST HOTEL” block. Those staying at the host hotel, by signing this agreement, 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
REGISTRATION/CHECK IN MANDATORY CHECK IN: Thursday, July 11, 2013 – 5:00 – 8:00pm – GALLERY ONE – FT. LAUDERDALE - DOUBLTREE SUITES HOTEL, 2670 E. Sunrise Blvd., Ft. Lauderdale, FL 33304 . Room to be designated. In case of emergency or hardship, call the promoter for a check-in on: Friday, July 12, 2013 8:00am – 8:30am – War Memorial Auditorium (Contest Site). Athlete meeting at 9:30am – PREJUDGING STARTS AT 10:00AM – EVENING SHOW AT 6:00PM.
GENERAL INFORMATION MUSIC : Music will be used for the Fitness Routine (Round #2). Contestants must provide a CD cued to their exact music - maximum time 2 minutes. No profanity is allowed on the CDs. Jewelry may be worn, Thong swimsuits will not be allowed, and the workable stage area is 45' long by 30' deep. It is a flat floor and there will be no platforms. TANNING: On-Site/Backstage Tanning will be provided by Hot Spot of Sarasota. Tanning will be available to the competitors on Thursday at the host hotel (Gallery One - Ft. Lauderdale Doubletree Suites Hotel), 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 CROSSOVERS: Contestants may enter one other contest in addition to their primary event – subject to their being qualified. Competitors may not enter more than one age group competition. Additional entry fee: $30.00. Per NPC Rules, no crossovers allowed between fitness, figure & bikini. AWARDS– All contestants in the Fitness, Figure & Bikini will receive a contest medallion, souvenir program and official contest t-shirt.
DETAILED CONTEST INFORMATION : Contact IFBB Fitness Pro/Contest Promoter Maria Bellando at 305-233-9257, 305-968-3318 or e-mail: mbfit1@bellsouth.net with any questions concerning the contest.
ENTRY FEE: $60.00 (Additional $30.00 for Crossovers). Entry fees are non refundable. Make check or money order payable to: MARIA BELLANDO and send to: MARIA BELLANDO. PROMOTER **Payment may be made using either Mastercard or Visa. Contact Maria at 305-233-9257 or 305-968-3318 for credit card processing DEADLINE: To be listed in the program, entries must be received on or before June 29, 2013 Late entries accepted up to and on July 12th - $30.00 late fee. PRINT, TEAR OFF & RETURN Click here for a printer friendly version of this application. Fill in the following: Entry Fee: $60.00 (Additional $30.00 for Crossovers).
EMAIL: ____________________________________________________________________________ In consideration of being allowed to participate in any way in the 2013 MARIA BELLANDO NPC SOUTHERN STATES FITNESS, FIGURE & BIKINI CHAMPIONSHIPS promoted by USA Sports Promotions of FL, Inc. and Maria Bellando and sanctioned by the National Physique Committee of the USA, Inc. (“NPC”), its related events and activities, I, Please print name_____________________________________________________), the undersigned, acknowledge, appreciate and agree that: The risk of injury from the activities involved in this Event is significant, including the potential for permanent paralysis and death, and while particular skills, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and, I KNOWLINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE PROMOTER AND/OR THE NPC or others, and assume full responsibility for my participation; and, I willingly agree to comply with the stated and customary terms and conditions for participation, if, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the Promoter immediately; and,I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS THE PROMOTER AND THE NPC and each of their officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used for the activity (“Releasees”), WITH RESPECT TO ANY AND ALL INJURY DISABILITY, DEATH, or loss or damage to person or property associated with my presence at or participation in or in traveling to and from the Event, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law. The undersigned further consents and agrees that the undersigned will comply with all rules and regulations of the Gallery One - Ft. Lauderdale Doubletree Suites Hotel including any rules or regulations prohibiting cooking or food preparation in the hotel rooms. The undersigned further agrees that the undersigned will indemnify and hold harmless the NPC and the Promoter from and against any damages caused by the undersigned to the Hotel or damages to a guest room or rooms occupied or registered to the undersigned. Finally, the undersigned acknowledges that the undersigned’s failure to comply with any rule or regulation of the Hotel or damage to any guest room occupied by or registered to the undersigned may result in disciplinary action against the undersigned including, but not limited to, suspension as a member of the NPC and/or competing in contests sanctioned by the NPC. And in further consideration of permission being granted to me to participate in the Event and its related events. I hereby grant the NPC, Promoter 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, television motion pictures, video, printing on digital 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. 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 any time in connection therewith. Nothing contained herein shall be deemed to obligate the NPC, Promoter, and/or any other NPC-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 the NPC, the Promoter and/or any NPC-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 the NPC, Promoter and/or any other NPC-approved video or entertainment organization hereunder. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVE UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. X______________________________________ Age:__________Date Signed:_________________ PARTICIPANTS SIGNATURE FOR PARENTS/GUARDIANS OF PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT TIME OF REGISTRATION) This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releasees, and, for myself, my child and our heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child’s involvement or participation in these programs as provided above, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law. X______________________________________ Age:__________Date Signed:_________________ PARTICIPANTS SIGNATURE
|
||||||||||||||||||||||||||||||||
|
