Bench Nationals Team Registation

1
Team Name
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2
Team Registration Number
Can be found here https://www.usapowerlifting.com/clubs/ or by contacting the national office
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3
Team Manager
First Name
Last Name
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4
Team Manager's Email
example@example.com
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5
Which Division are you entering?
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6
Note the five athletes that place the highest will score points for the team, no more than two athletes in any weight class. If there are more than two athletes in the same weight class the bottom two athletes points will be scored. Any athlete listed on opposing teams will be removed from both teams.
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7
Add your team members in the following fields.
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8
My Products* This field is required
My Bag
1
My Bag
Great Product Name
$20
Quantity:1
Size:Small
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Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
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ORDER SUMMARY
Total costUSD
Team Registration
$125.00+
Back
1
Quantity
Subtotal: $0.00
Total $0.00
Credit Card
First Name
Last Name
Credit Card Number
Security Code
Expiration Date
Postal Code
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Should be Empty: