BADGER JUDO TOURNAMENT Saturday September 30, 2017 USA Judo Sanction No. Applied For Fond du Lac, Wisconsin
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1 BADGER JUDO TOURNAMENT Saturday September 3, USA Judo Sanction No. Applied For Fond du Lac, Wisconsin LOCATION NEW DIRECTIONS SCHEDULE OF EVENTS ENTRY FEES Register early And save! COMPETITION STAFF PLEASE NOTE LOCATION Woodworth Middle School Gymnasium Morningside Drive Fond du Lac, Wisconsin From the West and North: Travel East on Hwy 3/Johnson Street, 3 ½ miles from the intersection of Hwy and 3, to Prairie Road. Turn right. Drive blocks to Morningside Drive. Turn right. Woodworth Middle School is blocks on the left. From Madison/Dubuque, etc: Drive N5 to Hwy 3/Johnson St offramp., turn left at offramp and drive mile to Prairie Road. Turn Left. Drive blocks to Morningside Drive. Turn right. Woodworth Middle School is blocks on the left. From Milwaukee/Chicago, etc.: Hwy North to Exit 5 and turn right on N5. Continue to Hwy 3/Johnson St offramp. Left/East on Johnson St and drive mile to Prairie Road. Turn Left. Drive blocks to Morningside Drive. Turn right. Woodworth Middle School is blocks on the left. :5 AM :3 AM Junior Registration and Weigh-Ins :5 AM : AM Senior/Master Registration and Weigh-Ins ABSOLUTELY NO JUNIOR WEIGH-INS ACCEPTED AFTER :3 : AM : AM Kata Competition : AM : AM Referee Meeting. Coaches, players, parents welcome : AM Junior Competition begins. Seniors and Masters will follow. HELP US BY REGISTERING ON LINE AT: Online Registration will open September, KATA ENTRY - team competition is $ per person per kata. Register at door. Competition will be for Nage no Kata, Katame no Kata, Ju no Kata and Goshin Jutsu. Other katas will be demonstration only. SHIAI ENTRY $ BY MAIL. Payment must accompany entry and be postmarked on or by September,. Mail to: Badger Open c/o Michael Blakeslee / Bryn Mawr Circle / Fond du Lac, WI 535 Check payable to: Wisconsin Judo. Any entry postmarked after September will be $5. $ REGISTER ON LINE by :5 PM Central, September,. Pay at the door. $5 REGISTER ON LINE by : PM Central, September,. Pay at the door. $6 REGISTER AT THE TOURNAMENT SITE $ FOR EACH ADDITIONAL DIVISION PER COMPETITOR Proof of valid national membership must be presented by all participants NO EXCEPTIONS USA Judo, USJF, USJA memberships available at tournament. Online USA Judo membership at regulation judo mats (-mxm) Round robin for divisions of 5 or fewer competitors. True Double Elimination pools for divisions of 6 or more. Match length: 3 minutes for Juniors and Masters. minutes for Senior divisions. Mixed Gender Pools allowed only for ages and under. Chokes allowed for ages 3 and up. Armlocks allowed in Senior and Master divisions except for brackets specifically designated as novice. If no novice bracket is available, players ranked below Sankyu may ask the referee to disallow armbars for that match. Golden Score will apply. Medals will be awarded for st, nd and 3 rd places at the completion of divisions. NOTICE TO COACHES: WJI Coaches Code of Conduct/Dress will be in effect for this tournament. Please contact Tournament Director with any questions. Since October is Breast Cancer Awareness Month: Referees may wear pink ties. Coaches may wear pink and players will be allowed to replace white (T-Shirt, Gi, belt) with pink. Tournament Directors: Mark Frankel / Welcome Mat (-5-3) Head Referee: Jerry Cypert Technical Official Coordinator: Tony Truskowski Registration/Pools Coordinator: Michael Blakeslee Medical Services: Barb Theisen, EMT Concessions and Judo Merchandise will be available at the tournament site. Tournament information available at or Lodging/Restaurant information available at or --3-3
2 JUNIOR DIVISIONS Each age division will be divided into weight groupings as determined by entries. Our goal is to keep Junior divisions within % of the lowest non-upgrade weight. Separate novice brackets may be created when there are sufficient entries to support adequate completion. Juniors adding additional competition outside of their primary bracket must have separate Consent for Junior Player to Compete in Additional Brackets or Consent for Junior Player to Compete in Senior Divisions signed by coach and parent in addition to the standard waiver. Mixed gender competition will only be allowed in yr and under brackets. With permission of parents and coach, females may request to play in a male bracket, but not vice-versa. Granting any request is at the sole discretion of the Tournament Director. 3 minute matches. Girls Age Divisions and under Boys Age Divisions 6 and under SENIOR DIVISIONS At the discretion of the tournament director, separate novice divisions may be created when there are sufficient entries to support adequate completion within the resulting brackets. Women: Weight classes will be determined by entries. minute matches. Men: Weight classes as listed below if enough players are registered to support good competition, otherwise by entries. minute matches. 3lbs/6kg 5lbs/66kg 6lbs/3kg lbs/kg lbs/kg lbs/kg +lbs/+kg MASTER DIVISIONS Ages 3 and over. Divisions: 3 / 5 and over if sufficient entries. Weight divisions will be determined by entries. 3 minute matches. KATA DIVISIONS There will be 3 divisions in each of the katas listed below. Participants may choose to do an entire kata or a portion of it based on their level of expertise. The Welcome Mat would like to encourage more judoka to participate through this facet of competition. Judo Kata is recognized as a part of Pan American Judo competition. NAGE NO KATA KATAME NO KATA JU NO KATA GOSHIN JITSU Novice Intermediate Advanced First 3 techniques, Te Waza Osaekomi Waza First 5 techniques, Tsuki Dashi through Ago Oshi First techniques, Ryote Dori through Kahae Dori First techniques, Te Waza, Koshi Waza, Ashi Waza Osaikomi Waza and Shime Waza First techniques, Tsuki Dashi through Katate Age First 5 techniques, Ryote Dori through Nanamezuki Entire Kata Entire Kata Entire Kata Entire Kata Tournament Director reserves the right to adjust divisions to ensure fair and safe competition.
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4 OFFICIAL BADGER ENTRY FORM September 3, For official Use only. DO NOT write in this box! Mod Fee: Entry Time: Entry # Family: Modified: Add Fee: Player# Membership Verified by: Base Fee: Official Weight: Last Name: First Name: MI: Gender: Age: Birth M/D/Y: Rank: System: Est. Weight: First or Only Division (Check one Below) Junior (ages 5-6) Senior (ages +) Master (ages 3+) For additional, optional competition when available, please check one or more from below (Additional fee may be required) Play up/down age bracket within division (Juniors or younger/ Masters 5+ only) [ADDITIONAL FEE] Play up in weight [ADDITIONAL FEE] Junior or Master playing Senior Division [ADDITIONAL FEE] If needed, I would play in additional NO FEE divisions that fit my weight and ability. Prefer Advanced if both Novice and Advanced divisions are available for primary bracket. National Org: (USA Judo, USJA, USJF) ID#: Insurance Expiration : School/Club: Instructor: Home Street Address: Phone: City: State/Prov: Zip/Postal Code: WAIVER AND RELEASE OF LIABILITY AND AGREEMENT TO PARTICIPATE In consideration of being permitted to participate in any way, including travel to and from, in any Judo tournament,practice, clinic and related events and activities of the United States Judo, Inc., United States Judo Federation,United States Judo Association, Wisconsin Judo Inc., the Fond du Lac School District Recreation Department, Fond du Lac Parks Department and Welcome Mat Judo Club, I hereby:. Acknowledge that I am familiar with the sport of Judo and understand the rules governing the sport of Judo and the importance of following these rules.. Agree that prior to participating, I will inspect the mats, equipment, facilities, competition pools or divisions, the elimination or scoring system to be used, along with the rules governing the activity I am participating in, and if I believe anything is unsafe or beyond my capability, I will immediately advise my coach or supervisor of such condition(s) and refuse to participate. 3. Acknowledge and fully understand that I will be engaging in a contact sport that might result in serious injury, including permanent disability, traumatic brain injury or death, and severe social and economic losses due to not only my own actions, inactions or negligence, but also to the action, inaction or negligence of others, the rules of the sport of Judo, or conditions of the premises or of any equipment used. Further, I acknowledge that there may be other risks not known to me or not reasonably foreseeable at this time.. Knowing the rules involved in the sport of Judo, I assume that risk and accept personal responsibility for the damages following such injury, permanent disability, traumatic brain injury or death. 5. Release, waive and discharge and covenant not to sue the United States Judo, Inc., United States Judo Federation, United States Judo Association, their affiliated clubs, their respective administrators, directors, agents, coaches, and other employees or volunteers of the organization, event officials, medical personnel, other participants, their parents, guardian(s), supervisors and coaches, sponsoring agencies, sponsors, advertisers and, if applicable, owners, lessors, and les sees of premises used to conduct the event, all of whom are hereinafter referred to as releasees, from any and all claims, demands, losses, or damages on account of injury, including permanent disability, traumatic brain injury and death or damage to property, caused or alleged to be caused in whole or in part by the negligence of the releasees or otherwise to the fullest extent permitted by law. 6. Photographs and images/video may be taken at any time. Your attendance at this activity will constitute your irrevocable consent to be photographed, videotaped and recorded, your irrevocable consent to the use of your likeness by Wisconsin Judo Inc. and others acting on its behalf, for the purpose of advertising and promotion in any media, throughout the world in perpetuity, including but not limited to television and the world wide web, and your waiver of any compensation or permission for such use. I HAVE READ THE ABOVE WARNING, WAIVER AND RELEASE, UNDERSTAND THAT I GIVE UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND KNOWING THIS, SIGN IT VOLUNTARILY. I AGREE TO PARTICIPATE KNOWING THE RISKS AND CONDITIONS INVOLVED AND DO SO ENTIRELY OF MY OWN FREE WILL. I AFFIRM THAT I AM AT LEAST YEARS OF AGE, OR, IF I AM UNDER YEARS OF AGE, I HAVE OBTAINED THE REQUIRED CONSENT OF MY PARENT/GUARDIAN AS EVIDENCED BY THEIR SIGNATURE BELOW. Participant (please print name) Participant s Signature FOR PARENTS/GUARDIANS OF PARTICIPANTS OF MINORITY AGE (UNDER AGE AT TIME OF REGISTRATION) This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release, as provided above, of all the Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liabilities related to my minor child s involvement or participation in these programs as provided above, even if arising from their negligence, to the fullest extent permitted by law. I have instructed the minor participant as to the above warnings and conditions and their ramifications. Parent/Guardian (please print name) Parent/Guardian Signature
5 KATA ENTRY FORM BADGER PLEASE FILL OUT A SEPARATE ENTRY FORM FOR EACH KATA PERFORMED. For official use only. Do NOT write in this box! Reg. ID# Entry Fee Paid Membership/Insurance Verified: Tori Uke Check One: NAGE NO KATA KATAME NO KATA JU NO KATA GOSHIN JITSU Entry Level Entry Level Entry Level Entry Level Intermediate Intermediate Intermediate Intermediate Advanced Advanced Advanced Advanced TORI: Last Name: First Name: MI: Sex: Age: Birth M/D/Y: Rank: National Org: ID# Insurance Expiration : (USA Judo, USJA, USJF, etc.) Judo Club: Home Address: City: State/Prov: Zip/Postal Code: Address: UKE: Last Name: First Name: MI: Sex: Age: Birth M/D/Y: Rank: National Org: ID# Insurance Expiration : (USA Judo, USJA, USJF, etc.) Judo Club: Home Address: City: State/Prov: Zip/Postal Code: Address: Please sign the WARNING WAIVER AND RELEASE OF LIABILITLY AND AGREEMENT TO PARTICIPATE on back.
6 Reg. ID#: Badger Judo Tournament September 3, WARNING! WAIVER AND RELEASE OF LIABILITY AND AGREEMENT TO PARTICIPATE In consideration of being permitted to participate in any way, including travel to and from, in any Judo tournament,practice, clinic and related events and activities of the United States Judo, Inc., United States Judo Federation, United States Judo Association, the Fond du Lac School District Recreation Department, Fond du Lac Parks Department and Welcome Mat Judo, I hereby:. Acknowledge that I am familiar with the sport of Judo and understand the rules governing the sport of Judo and the importance of following these rules.. Agree that prior to participating, I will inspect the mats, equipment, facilities, competition pools or divisions, and the elimination or scoring system to be used, and if I believe anything is unsafe or beyond my capability, I will immediately advise my coach or supervisor of such condition(s) and refuse to participate. 3. Acknowledge and fully understand that I will be engaging in a contact sport that might result in serious injury, including permanent disability or death, and severe social and economic losses due to not only my own actions, inactions or negligence, but also to the action, inaction or negligence of others, the rules of the sport of Judo, or conditions of the premises or of any equipment used. Further, I acknowledge that there may be other risks not known to me or not reasonably foreseeable at this time.. Knowing the rules involved in the sport of Judo, I assume that risk and accept personal responsibility for the damages following such injury, permanent disability or death. 5. Release, waive and discharge and covenant not to sue the United States Judo, Inc., United States Judo Federation, United States Judo Association, their affiliated clubs, their respective administrators, directors, agents, coaches, and other employees or volunteers of the organization, event officials, medical personnel, other participants, their parents, guardian(s), supervisors and coaches, sponsoring agencies, sponsors, advertisers and, if applicable, owners, lessors, and lessees of premises used to conduct the event, all of whom are hereinafter referred to as releasees, from any and all claims, demands, losses, or damages on account of injury, including permanent disability and death or damage to property, caused or alleged to be caused in whole or in part by the negligence of the releasees or otherwise to the fullest extent permitted by law. I HAVE READ THE ABOVE WARNING, WAIVER AND RELEASE, UNDERSTAND THAT I GIVE UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND KNOWING THIS, SIGN IT VOLUNTARILY. I AGREE TO PARTICIPATE KNOWING THE RISKS AND CONDITIONS INVOLVED AND DO SO ENTIRELY OF MY OWN FREE WILL. I AFFIRM THAT I AM AT LEAST YEARS OF AGE, OR, IF I AM UNDER YEARS OF AGE, I HAVE OBTAINED THE REQUIRED CONSENT OF MY PARENT/GUARDIAN AS EVIDENCED BY THEIR SIGNATURE BELOW. Tori (please print name) Tori s Signature Uke (please print name) Uke s Signature FOR PARENTS/GUARDIANS OF PARTICIPANTS OF MINORITY AGE (UNDER AGE AT TIME OF REGISTRATION) This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release, as provided above, of all the Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liabilities indicent to my minor child s involvement or participation in these programs as provided above, even if arising from their negligence, to the fullest extent permitted by law. I have instructed the minor participant as to the above warnings and conditions and their ramifications. Tori s Parent/Guardian (please print name) Parent/Guardian Signature Uke s Parent/Guardian (please print name) Parent/Guardian Signature
7 Badger Judo Tournament September 3, Consent for Junior Player to Compete in Additional Brackets Note to coaches, parents, and competitors. This form MUST be signed by all parties before a junior competitor will be allowed to compete in additional non-primary brackets. ABSOLUTELY NO JUNIOR WITHOUT THE CONSENT FORM SIGNED BY THE COMPETITOR, COACH, AND PARENT WILL BE ALLOWED IN COMPETITION OUTSIDE THEIR PRIMARY BRACKET. The undersigned parent/legal guardian and coach of (name of competitor), hereby express our consent and approval that he/she may enter the ( ) next higher weight group in the same age group, or ( ) next higher age group, at the same weight group. We are fully aware that this is not the normal age/weight division for him/her. We are further aware that persons entering this division may be older, heavier and/or more experienced than him/her and that there will be no age waiver for chokes if he/she is allowed to enter the divisions for 3 and older. Printed name of competitor Printed name of competitor s coach Printed name of competitor s parent/guardian _ Competitor s signature _ Coach s signature _ Parent/Guardian s signature PlayerId EntryId School/Club National Org For Official Use Only ID# Expiration
8 Badger Judo Tournament September 3, Consent for Junior Player to Compete in Senior Divisions Note to coaches, parents, and competitors. This form MUST be signed by all parties before a junior competitor will be allowed to compete in Senior Divisions. ABSOLUTELY NO JUNIOR WITHOUT THE CONSENT FORM SIGNED BY THE COMPETITOR, COACH, AND PARENT WILL BE ALLOWED IN SENIOR DIVISIONS. This certifies that (name of competitor) is of sufficient skill, aptitude, and maturity to compete in the senior division. The competitor, coach, and parent certify that they understand that the junior competitor will be competing under the rules governing the senior division competitions and may be subjected to all techniques allowable in that division. Printed name of competitor Printed name of competitor s coach Printed name of competitor s parent/guardian _ Competitor s signature _ Coach s signature _ Parent/Guardian s signature PlayerId EntryId School/Club National Org For Official Use Only ID# Expiration
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