Idenity Notice

INDEMNITY STATEMENT

I, the undersigned

……………………………………………………………………………………………………………………………………………………………….

Date of Birth: …………………………………………………………………………………………………………………………………………

1. I understand the Rules promulgated in terms of the Constitution of the Global
Powerlifting Committee and other internal GPC documents (the rules of powerlifting,
etc.).

2. There are inherent risks associated with participation in the 2013 GPC European.
Championships which may result in personal injury (even of a serious nature) to me. I
am aware of the risks and accept these risks.

3. To the full extent permitted by law, I absolve, release, discharge and indemnify the
GPC, its officers, employees, organisers, representatives, helpers/spotters/loaders
and/or agents (“the Indemnities”) from any and all liability from any and all claims,
demands, rights or action or causes of action, present or future, resulting from or
arising out of my participation in the Championships, for any personal injury, mental
anguish, loss or damage of any kind suffered by me.

4. In the event of such injury, first aid may attend to me while injured. Should I have to
receive treatment at a hospital or any medical institution due to any injury I will be
responsible to pay my own expenses.

5. I declare that I have read and understood the above and accept full responsibility for
my safety during my participation in these Championships, and I waiver any claim I
might have against the GPC and/or the Indemnities. I was not unduly influenced and
sign this form freely and voluntarily.

Signature……………………………………………

Date: ……………………………………….

NOTE: In the case of a minor (any person under the age of 21 years of age) I confirm that
my parent(s) and/or legal guardian who has been notified of my intended participation in the
Championships and has given his / her / their permission to do so.

Each participant must confirm this document with his signature on the registration as a
sign of his consent.

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