Division*
Athlete's Release from Liability and Consent to Drug Test Form:
In consideration of the acceptance of my entry in this power lifting competition, I intend to be legally bound, do hereby, for myself and my heirs, executors and administrators waive, release and accept the risk for and forever discharge any and all rights and claims for damages which I may have, or which may hereafter accrue against the USAPL, the East Swamp Church, the local hosts, facility owners and other support organizations, their respective officers, agents, representatives, members, employees, volunteers and successors involved.
Moreover, I agree that any testing method which the meet director(s) and the sponsors of this meet use to detect the presence of strength-inducing drugs and controlled/banned substances shall be conclusive. That is, whether I think the results of the test are right or wrong, I agree that I have no right to challenge the results of the drug test. I further agree to submit to any physical test which may be necessary to complete drug testing. Should I fail the drug test, I agree to waive any claim which might arise under state or federal law for defamation, slander, libel or any other claim for which legal relief is available. If it is determined that I have failed the drug test, I agree to forfeit any trophy or award which I might have otherwise won.
Except during drug testing, I hereby authorize the USAPL and/or its designated representatives to allow the reproduction, dissemination and/or publication of my name and likeness for media coverage, public relations or any other purpose which involves the use of photographs, films, video or audio tape recording.
I have carefully read all of the above and I fully understand and agree with all of its contents. In acknowledgement hereof, I will enter my signature and today's date below.
USAPL BANNED SUBSTANCES LIST
The intent of this list is to inform athletes of substances that are not allowed by the USAPL. Please note that this list is NOT all inclusive and that it is ultimately the athlete's responsibility to know what he or she is taking. The athlete is also responsible for his or her testosterone:epi-testosterone (T: E) ratio. DO NOT use any substance before checking with your physician or the USOC Drug Reference Line at 1 800 233-0393. When in doubt, ask or check www.wada-ama.org
The following is a list of classes of banned drug with examples of substances under each class:
Anabolic agents / anabolic steroids:
Androstenediol androstenedione boldenone clostebol dehydrochloromethyltestosterone dehydroepiandrosterone (DHEA) dihydrotestosterone (DHT) dromostanolone epitrenbolone fluoxymesterone gestrinone mesterolone methyltestosterone nandrolone norandrostenediol norandrostenedione norethandrolone oxandrolone oxymetholome stanozolol testosterone tetrahydrogestrinone (THG) trenbolone methanedione methenolone clenbuterol and related compounds.
Diuretics: acetozalimide benzhiazide chlorothiazide furosemide and related compounds
Peptide hormones and analogues:
Corticotrophin (ACTH) human chorionic gonadotrophin (HCG) luteinizing hormone (LH) growth hormone (HGH, somatotrophin) insulin-like growth factor (IGF-1)
Stimulants:
Amiphenazole amphetamine bemigride benzphetamine bromantan chlorphentermine cocaine diethylpropion dimethylamphetamine ephedrine (ma huang) ethylamphetamine fencamfamine meclofenoxalate methamphetamine methylenedioxymethamphetamine (MDMA, ecstasy) methylphenidate nikethamide pemoline pentetrazol phendimetrazine phenmetrazine phentermine phenylpropanolamine (ppa) picrotoxine pipradol prolintane strychnine synephrine (citrus aurantium, bitter orange, zhi shi) and related compounds.
Manipulation of urine sample:
The use of substances and methods that alter the integrity and/or validity of urine samples provided during USAPL drug testing is banned. Examples include catheterization, urine substitution and/or tampering or modification of renal excretion by the use of diuretics, probenecid, bromantan or related compounds and epitestosterone administration.
I hereby give my word of honor as an athlete that I have not used any banned substances as listed above as part of my training during the past 60 months (5 years), nor have I used any prescription diuretics or any psychomotor stimulants during the seven days before the contest.
I have carefully read all of the above and I fully understand and agree with all of its contents. In acknowledgement hereof, I will enter my signature and today's date below.
