SOUTH AFRICAN POWERLIFTING FEDERATION

Detail required for Nomination in the upcoming Championships. Please complete all fields below. Hint: If are registered and logged into the website, your details will be pre-populated into the required fields. Register at http://www.powerliftingsa.co.za/user/register

NOTE: For this competition, entry fee of R600 (add R200 for additional age division) must be paid into the following account, and the proof of payment attached on this form below:
JOHAN SMITH POWERLIFTING UNLIMITED
FNB 62604351122, Branch 250437 (with your name as reference)