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<strong>NATURAL</strong> <strong>OLYMPIA</strong> <strong>2013</strong><br />
OFFICAL ENTRY FORM<br />
PLEASE PRINT NEATLY * SEND ENTRY IN NOW<br />
MUST BE A MEMBER OF THE <strong>INBA</strong> TO COMPETE<br />
NAME_________________________________________________________________<br />
ADDRESS_______________________________________________CITY__________<br />
STATE______ POST CODE__________ PHONE NUMBER __________________<br />
OCCUPATION_________________AGE_______HEIGHT_______WEIGHT_____<br />
<strong>INBA</strong> MEMBERSHIP #______________ EXP DATE _______________________<br />
E-MAIL_________________________YOUR GYM NAME_____________________<br />
TITLES WON__________________________________________________________<br />
_______________________________________________________________________<br />
_______________________________________________________________________<br />
INTERESTS____________________________________________________________<br />
_______________________________________________________________________<br />
_______________________________________________________________________<br />
_______________________________________________________________________<br />
Category/Class Name:__________________Please Tick (Men___ Women___)<br />
(Open__/Teen__/Masters__/Grand Masters__/Ultra Masters__/Super__/ PRO__)<br />
Category/Class Name:__________________Please Tick (Men___ Women___)<br />
(Open__/Teen__/Masters__/Grand Masters__/Ultra Masters__/Super__/ PRO__)<br />
Category/Class Name:__________________Please Tick (Men___ Women___)<br />
(Open__/Teen__/Masters__/Grand Masters__/Ultra Masters__/Super__/ PRO__)<br />
SIGNATURE______________________________________________________<br />
PARENT'S SIGNATURE_________________________________(If Under 18)<br />
Upon signing the above, I will be legally binding myself, my heirs, my executors, administrators and assigns<br />
to waive and release any and all claims or rights for injuries or damages suffered by me against Kakos<br />
Productions, Mt. Olympus Inc., ABA, <strong>INBA</strong>,PNBA, IFSB,NFSB, facility, city, county, Ms. Fitness, their<br />
officers, agents, employee's, sponsors, co-sponsors, officials, sub contractors. I will participate in this event<br />
as a contestant. Further, I hereby grant full permission to any and all of the foregoing to use photographs,<br />
video tapes, motion picture recordings, or any other record of this event for any purpose. I have had an<br />
opportunity to review the <strong>INBA</strong>/PNBA Anti-Doping rules listed on th Naturalbodybuilding website. I further
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