NAME____________________________________AGE________________

In the space provided, list what you would like the announcer to say:

STREET ADDRESS_____________________________________________

__________________________________________________________

CITY/STATE/ZIP CODE_________________________________________

__________________________________________________________

PHONE NUMBER_______________________________________________

__________________________________________________________

E-MAIL________________________________________________________

__________________________________________________________

TEAM_________________________________________________________

TRAINER_________________________________________________

In consideration of accepting this entry, I hereby, intending to be legally bound for myself, my heirs, executors and administrators,(i) Waive any and all rights and claims for damages I may have against Arkansas State
Championships, Chad Nicholls, Kim Chizevsky-Nicholls, The National Physique Committee of the U.S.A., Inc. (NPC), the Statehouse Convention Center, or the agents, employees, representatives or assigns of any of the foregoing
persons or entities for any and all injuries or damages I may incur while traveling to and from, or participating in, this competition (ii) I certify that I am an amateur in good standing and am eligible to compete in this competition in the
division(s) in which I have entered, and (iii) I further agree to abide by all decisions of the NPC and declare that all information contained herein is, to the best of my knowledge, true, correct and complete.

Competitors Signature_____________________________ Parent/Guardian Signature (If under 18 years of age) _____________________________

NPC CARD#______________________________________

COMPETING IN: Check Division(s) entered please note

Submit $75.00 for EACH Division entered

ENTRY FEE: $75.00 For EACH Class entered NO REFUNDS ______Teen Men BB
Cut along line below and mail with check, cash or money order to:

Chad Nicholls, P.O. Box 9101, Springfield, MO 65801

(Make Checks Payable to Chad Nicholls)
MayhemMailBag@aol.com

______Mens Novice BB
______Mens Open BB
______Masters Men BB
______Womens Novice BB
______Womens Open BB
______Masters Women BB

______Novice Figure
______ Open Figure
______Masters Figure
______ Novice Bikini
______Open Bikini
______Masters Bikini
______Womens Fitness

_______Wheelchair
_______Novice Womens Physique
_______Open Women Physique
_______Masters Womens Physique
_______Novice Mens Physique
_______Open Mens Physique
_______Master Mens Physique

YOU MUST LIST YOUR WEIGHT AND/OR HEIGHT CLASS BELOW:

*Entries must be postmarked by JULY 20, 2015 to avoid $75.00 late fee. __________________________________________________________
ALL ENTRY CONFIRMATIONS WILL BE SENT VIA EMAIL

Weigh/Check-Ins:

MANDATORY CHECK-IN/WEIGH-IN FOR ALL COMPETITORS IN ALL CLASSES - MANDATORY

Friday, July 31, 2015 The Little Rock Marriott; 3 Statehouse Plaza, Little Rock, AR - FROM 4:00p.m. 6:00p.m.

Date & Times:

SATURDAY, AUGUST 1, 2015 Athlete Meeting 8:30 a.m. - Pre-judging 10:00 a.m. - Meeting 5:30 p.m. - Finals 6:00 p.m.

Place:

STATEHOUSE CONVENTION CENTER, Markham & Main St.; #1 Statehouse Plaza, LR, AR 72201

Promoters:

Chad Nicholls & Kim Chizevsky; P. O. Box 9101, Springfield, MO 65801

Divisions:

Men: Bantam Wt. 143 and under, Light Wt. over 143 and up to and including 154 , Middle Wt. Over 154 and up to and including
176 , Light Heavy Wt. - over 176 and up to & including 198 , Heavy Wt. - over 198 and up to & including 225, Super Heavy Wt. -over 225
Women: Light Wt. 114 and under, Middle Wt. over 114 and up to & including 125 , Heavy Wt. - Over 125 Masters Men: 3 Classes 35
39 years old, 40 49 years old and 50 & older; Masters Women: 1 class 35 & Over Novice Men Light Wt. Up to and including 154 , Middle
Wt. Over 154 and up to & including 176 , Light Heavy Wt. Over 176 and up to & including 198 , Heavy Wt. Over 198 Novice Women
One Class - Teen Men One Class - Fitness Competitors One Class Novice Figure One Class Open Figure Two classes A & B, Masters
Figure Competitors One Class 35 years and over - Novice Bikini One Class Open Bikini - Two Classes A & B - Masters Bikini Competitors
- One Class 35 years and over - Wheelchair Division Mens and Womens classes Novice Mens Physique One Class Open Mens Physique
Two Classes A & B - Masters Mens Physique - One Class 35 years and over Novice Womens Physique One Class -Open Womens Physique
One Class - Masters Womens Physique - One Class 35 years and over

Eligibility:

THIS EVENT IS OPEN TO ALL REGISTERED NPC ATHLETES: (1) Each competitor must be a current member with the NPC - To meet this
requirement, he/she must present his/her current NPC card, current NPC Receipt, or purchase your NPC card at this event ($120). (2) Each competitor must
be an amateur in good standing with the NPC. MASTERS (Men & Women): Each competitor in these Divisions also (1) by August 1, 2015 must have
reached the age for the respective Masters class in which he/she has chosen to compete (2) and must provide proof of age with a birth certificate, drivers
license, state i.d. FIGURE & BIKINI: One (1) round two-piece swimsuit. FITNESS: Two (2) rounds two-piece swimsuit & routine round. TEEN
CLASS: Each competitor in this Division must (1) have reached his 13th birthday, but not his 20th birthday, by August 1, 2015, and (2) must provide proof
of age with a birth certificate, drivers license or state i.d. MENS PHYSIQUE: One (1) round Surf style board shorts. No shirt, sneakers or sandals are
to be worn on stage. WOMENS PHYSIQUE: Two (2) rounds Physique Assessment & Individual Routine Round.

Awards:

Beautiful Awards will be presented to places 1 5 in all classes. Awards will be presented to the Overall Champions. Specialty Awards: Mens Most
Muscular - Womens Conditioning Arkansas Best Poser Top Team Award - This is a National Qualifying event for ALL Open Divisions.

Rules:

ABSOLUTELY NO DREAM TAN IS TO BE USED!!! Light Oil is allowed. Athletes who compete in the pre-judging must compete in the evening show.
Bodybuilders are to wear suits of a single color to prejudging; Womens Physique, fitness, figure & bikini may wear multi-colored suits that may be
embellished and may wear tasteful jewelry. Mens physique is to wear board style shorts. Athletes must exhibit good sportsmanship at all times. Only
competitors and officials are allowed backstage and in the pump-up room. NO EXCEPTIONS NO KIDDING! CURRENT NPC RULES APPLY.

Posing/ Music:

All athletes will be presented or perform posing routines to music in the Evening Finals. All posing routines will be limited to 60 seconds in length.
COMPETITORS IN CATEGORIES THAT REQUIRE A POSING ROUTINE: Please email your music to our sound tech Bryan at:
bryan_mycoff@yahoo.com . Acceptable formats for emailing your routine music are: .wma; .mp3; .asf & .wmv. CD files ending in .cda are NOT
acceptable as they DO NOT contain audio files. Even if you email your music, please bring 2 backup CDs with you to the check-ins. CDs must be cued
to the beginning of the CD CDs containing multiple songs will NOT be accepted. NO PROFANITY IS ALLOWED IN MUSIC - PERIOD!

Hotel:

Discounted lodging is available through the Little Rock Marriott (Formerly The Peabody) at (501) 906-4000 (Please mention the Arkansas State
Championships to obtain a discounted rate) All reservations must be made no later than JULY 20, 2015 TO SECURE YOUR ROOM.