Gene Lewis Boxing Club, Inc. presents The 40th Annual Gene Lewis Invitational Boxing Tournament November 12, 13, 14, 2015 Thursday - Friday - Saturday Bouts Begin Thursday and Friday at 7:00 pm Saturday at 1:00 pm Entry Forms and Information available at: www.genelewisboxingclub.com Gene Lewis Boxing Club Gym: (480) 834-1216 Broadway Recreation Center 59 East Broadway Mesa, Arizona $7.00 Admission
GENE LEWIS BOXING CLUB, INC. P.O. BOX 930, MESA, AZ 85211 40th ANNUAL Mesa Invitational Amateur Boxing Tournament November 12, 13, 14, 2015 MEN S DIVISION Registration Form ENCLOSE $12 REGISTRATION FEE WITH EACH FORM NO EXCEPTIONS - NO REFUNDS CIRCLE DIVISION ENTRY AGE: 9 & 10 50 55 60 65 70 75 80 85 90 95 100 105 110 AGE: 11 & 12 60 65 70 75 80 85 90 95 101 106 110 114 119 125 132 138 145 AGE: 13 & 14 70 75 80 85 90 95 101 106 110 114 119 125 132 138 145 154 165 176 189 201 (Females Same as Males Weights) AGE: 15 & 16 80 85 90 95 101 106 110 114 119 125 132 138 145 154 165 176 189 200 201+ (Females up to 189+) MALE 17-40 108 114 123 132 141 152 165 178 201 201+ FEMALE 17-18 106 112 119 125 132 141 152 165 178 178+ FEMALE 19-40 106 112 119 125 132 141 152 165 178 178+ WOMEN S and GIRLS DIVISION (Girls subject to number of entries) Novice (if available entries) Name Age Weight Representing Boxing Club Address City State Zip Passbook No. Experience: Won: Lost: Major tournaments the boxer has won: RETURN APPLICATIONS TO: GENE LEWIS BOXING CLUB P.O. BOX 930 MESA, AZ 85211
DAYS HOTEL MESA/GILBERT $64.99 WELCOME BACK!!! November 11, 12, 13, 14 & 15, 2015 Hot Breakfast Buffet Beautiful Resort- style Pool Fitness Center Free WI- FI Be sure to ask for the CONGRAULATIONS ON 40 GREAT YEARS!!
GENE LEWIS BOXING CLUB, INC. 40th MESA INVITATIONAL AMATEUR BOXING TOURNAMENT TIME: Tournament is scheduled for November 12, 13, 14, 2015 7:00 PM THURSDAY& FRIDAY - 12:30 PM SATURDAY HEADQUARTERS: REGISTRATION INFORMATION: GENE LEWIS BOXING CLUB BROADWAY RECREATION CENTER 59 E. BROADWAY ROAD MESA, ARIZONA $12 REGISTRATION FEE ALL BOXERS MUST BE CURRENTLY REGISTERED WITH USA BOXING, INC. IN THEIR HOME STATE FOR INSURANCE AND SANCTION PURPOSES. WEIGH-INS AND PHYSICALS: THURSDAY, NOVEMBER 12-7AM TO 10AM FRIDAY, NOVEMBER 13-7AM TO 9AM SATURDAY, NOVEMBER 14-7AM TO 9AM ORIENTATION THURSDAY, NOVEMBER 12-10:00 AM TO NOON
WEIGH-INS: Weigh-ins are on Thursday morning (November 12) from 7:00 AM to 10:00 AM, Friday morning (November 13) from 7:00 AM to 9:00 AM and Saturday morning (November 14) from 7:00 AM to 9:00 AM. PHYSICALS: All physicals will be conducted at 5:30 PM each evening during the tournament for those participating that night. OFFICIALS: A brief officials meeting will be held before the bouts at 6:00 PM on Thursday, Friday and Saturday at 11:00am. All out-of-state officials must be registered USA Boxing and are welcome to participate. COACHES: Bring your own lock; showers are available. PAIRINGS: Pairings will be made at approximately 10:30 AM following the coaches meeting; all coaches are urged to attend. ALL MEETINGS, WEIGH-INS, PHYSICALS AND BOUTS WILL BE HELD AT THE BROADWAY RECRE- ATION CENTER, 59 E. BROADWAY (SEE MAP BELOW) LOCKERS: Bring your own lock; showers are available. USA PASSBOOK: All boxers must be currently registered with the USA BOXING INC. in THEIR APPROPRIATE STATE for insurance and sanction purposes.
UNITED STATES AMATEUR BOXING INC. Female Athlete Acknowledgement Name of Event: Mesa Invitational Amateur Boxing Tournament Date: November 12, 13, 14, 2015 Sanction # Sanctioned by USA Boxing, Arizona Association and United States Amateur Boxing, Inc. (Section above to be completed by Sanction Holder) Must be completed and signed by female athletes each time they complete. Name: LBC Name & #: Address: Street City State Zip Code Birth date: USA Boxing Registration # Acknowledgement I CERTIFY THAT I AM NOT PREGNANT, OR HAVE ANY PAINFUL PELVIC DISCOMFORT SUCH AS SYMPTOMATIC ENDOMETRIOSIS OR OTHER CAUSES, ABNORMAL VAGINAL BLEEDING OF UNDETERMINED CAUSES (ETIOLOGY), RECENT LOSS OF MENSTRUAL PERIOD (SECONDARY AMENORRHEA), RECENT BREAST BLEEDING, RECENTLY DEVELOPED BREAST MASS, RECENT BREAST DYSUNCTION PREVIOUSLY NOT PRESENT OR SURGICAL BREAST IMPLANTS, AND HAVE READ SECTION 101.9(4) OF USA BOXING S OFFICIAL RULES PERTAINING TO MY PRESENT PHYSICAL CONDITION. I FURTHER AGREE THAT I WILL IMMEDIATELY NOTIFY MY COACH, TRAINER OF OTHER LOCAL BOXING OFFICIALS IF ANY OF THE ABOVE DESCRIBED CONDITIONS SHOULD DEVELOP/APPLY AND WILL IMMEDIATELY DISQUALIFY MYSELF AND CEASE PARTICIPATION IN THE ABOVE EVENT. (SECTION 101.9(4) OF USA BOXING S OFFICIAL RULES IS INCORPORATED IN THIS ACKNOWLEDGEMENT BY REFERENCE). I, the undersigned, have read this Acknowledgement. Signed: Date: (Participant s Full Name) Signed: Date: (Participant s Legal Guardian) *REQUIRED IF ATHLETE IS A MINOR