NGA Purebody Nutrition Extravaganza

Men's Physique Entry Form

 

Saturday, July 21, 2012

 ELIGIBLE:              All Males

 

PLACE:                   Caldwell Auditorium 300 S. College Ave Tyler, TX, (There is a $5 parking charge)

                            

 MEETING:               This is a mandatory meeting, Friday July 20 at ________

 

 TIME:                      PREJUDGING: 10:00 am (SHARP)

EVENING: SHOWTIME 6:00 PM - DOORS OPEN: 5:30 PM

ENTRY FEE:            $50.00 TO ALL CONTESTANTS/$25.00 TO CROSSOVER

                               Make checks or Money Orders payable to: Purebody Nutrition. Entry fees are non refundable. 

                               Entry forms will not be accepted without payment.  After July 6, 2012 Entry Fee is $75, no crossovers.

                               No Entries after July 11, 2012.

 

TESTING:                No testing needed. all eligible

   

INFO:                       If you have any questions, Call Alicia Burgin 903-939-9232 begin_of_the_skype_highlighting            903-939-9232      end_of_the_skype_highlighting

 

SEND CHECK/ MONEY ORDER/ ENTRY FROM:  PureBody Nutrition, Alicia Burgin, 6747 S. Broadway, Tyler, TX 75703

 Tickets:                  Prejudging:  $10 General Admission; $25 Reserved

                  Finals:  $10 in advance or $15 at the door for General Admission.  $30 Reserved.

                 Reserved Combo: (Prejudging and Finals):  $45

      Children under 10 accompanied by adult FREE (must have a free child ticket)

                                                                                                                                                                                   

Contest Hotel:     to be announced                 

NGA PureBody Nutrition Extravaganza 2012

 

Men's Physique                              (   )  MEN                                              

                                                 

                                            

 NAME_____________________________________________ AGE__________ DATE OF BIRTH________________________________

 

ADDRESS_________________________________________ CITY__________________ STATE __________   ZIP_________________

 

E-MAIL__________________________________________________________________________________________

 

Cell Phone_______________________                                                                                         

 WAIVER: By your accepting my application to the 2012 Purebody Nutrition Extravaganza, along with my non-refundable entry fee, I herby intend to be legally bound for myself, my heirs, executors and administrators.  I waive and release any and all rights and claims for damages I may have against PureBody Nutrition, Will and Alicia Burgin, all sponsers, Caldwell Auditorium, agents and representatives for any and all injuries and or losses suffered by me as a result of my participation and or attendance and traveling to the 2012 Purebody Nutrition Extravaganza July 21, 2012.  These damages include, but are not limited to, published photographs that I may find to be unattractive or editorial which I may construe as being misrepresentatice. I give Will and Alicia Burgin the right to refuse me as a competitor, without refund of money, if I am not appropriately dressed in board shorts, competition tan and without any logos of any kind.  I also grant 2012 Purebody Nutrition Extravaganza, promoter Will and Alicia Burgin , permission to use photos, video or any likeness of myself to promote any future contests and Purebody Nutrition, videos, magazines or any other media involved with future and present contest for the purpose of promotion and /or sales of these media, without any compensation to myself, as condition of my entering the event.  

 SIGNATURE_______________________________________________________________________________   DATE ____________________________

 

SIGNATURE  OF  PARENT  OR  GUARDIAN (If  under  18)__________________________________________  DATE ____________________________