2012 Shaunavon Open Taekwondo Championships

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1 2012 Shaunavon Open Taekwondo Championships DATE: SATURDAY, April 21, 2012 LOCATION: Crescent Point Wickenheiser Centre Shaunavon, Saskatchewan ACCOMMODATION: The OIL industry has booked accommodation We have rooms in Swift Current?????????????? Based on spring breakup we may get rooms in town Standby for billets, church halls and trailors Limited rooms available. Please book early. REGISTRATION: Registrations accepted until APRIL 10, allenh2op@yahoo.ca or Fax: (306) Payment for Registration Fees (cheques/money orders) made payable to: Shaunavon Open Taekwondo Championships, can be mailed to: Pete Allen, Box 843, Shaunavon, SK, S0N 2M0 ELIGIBILITY: RULES: All competitors must be members in good standing of an established WTF Taekwondo school, and recognized by their Provincial Taekwondo association. Colour Belt Tournament only. No Black Belt Divisions. Current WTF Rules Exception: ABSOLUTELY NO HEAD CONTACT

2 EQUIPMENT: Chest and head gear must be supplied and worn by contestants. Shin and arm guards must be supplied and worn by contestants. Mouth guards are mandatory. Males must supply and wear athletic support cup. ENTRY FEE: $30.00 for One Division $40.00 for Two Divisions $40.00 for Three Divisions Divisions: Sparring, Patterns, Board Breaking Cheques Payable: Shaunavon Open Taekwondo Championships EVENT TIMES: Referees and Judges Meeting 9:00 a.m. Competitors Line-up Children 15 years and under Adults over 15 years 9:30 a.m. 10:00 a.m. 1:00 p.m. ADMISSION: $5.00 AT DOOR Children 8 years and under free when accompanied by adult Seniors free when accompanied by a child INFORMATION: Call (306) , or Fax (306)

3 **** 2012 Shaunavon Open Taekwondo Championships **** COMPETITOR S REGISTRATION FORM (PLEASE TYPE OR PRINT CLEARLY IN BLACK OR BLUE INK) Name: last first middle Home Address: City: Prov: Postal Code: Phone #: ( ) Address: Date of Birth: / / Age: Height: Weight: Yr. Mo. Day (please be accurate with height/weight; both needed if sparring) Your Sparringi division will be based on this information only Taekwondo School Name: Phone #: ( ) TKD Instructor: TKD Master: Please Circle Your Correct Rank White Belt 10 th Gup Yellow Stripe 9 th Gup Yellow Belt 8 th Gup Green Stripe 7 th Gup Green Belt 6 th Gup Blue Stripe 5 th Gup Blue Belt 4 th Gup Red Stripe 3 rd Gup Red Belt 2 nd Gup Black Stripe 1 st Gup Jr. Black Belt Poom Black Belt Dan ******************************************************** Check Appropriate Categories Below $30.00 for One Division $40.00 for Two Divisons $40.00 for Three Divisions Male Female Gyoroogi Poomse Kupka (Sparring) (Patterns) (Board breaking) Cheques payable to : Shaunavon Taekwondo Open Championships Please fax or Pete Allen at: allenh2op@yahoo.ca Fax: (306)

4 *******READ BEFORE SIGNING******* In consideration of your acceptance of my entry, I do hereby, for myself, my heirs, executors, and administrators, waive, release, and forever discharge all rights and claims for damages which I may have, or which may accrue to me against the 2012 Shaunavon Open Taekwondo Championships, The WTF Taekwondo Association of Saskatchewan, The WTF Taekwondo Association of Canada, The World Taekwondo Federation, and all members of the tournament, or their respective officers, agents, representatives, successors, and/or assigns, and against any competitor for any and all damages which may be sustained by me in connection with my association with, or entry in the above athletic meet. I understand that Taekwondo is a body contact sport, which involves a risk of injury. I understand that the competition rules are based on the rules of the World Taekwondo Federation. I agree to all tournament competition rules and understand that I may be disqualified if I do not follow these rules. If I fail to show up to the competition, I knowingly forfeit all applicable registration fees. I further understand that any pictures taken of me in connection with the 2012 Shaunavon Open Taekwondo Championships can be used by the Tournament Director for publicity or promotion without compensation at this time, or any time. Applicant Signature: Date: FOR ATHLETES OF MINORITY AGE (UNDER THE AGE OF 18 AT THE TIME OF REGISTRATION) This is to certify that I, as the parent/guardian of this participant, have explained to my son/daughter the aforementioned stipulated conditions and their ramifications and I consent to his/her participation in the above championship. Date Signed: Parent/Guardian Signature Relationship: Parent/Guardian Name (Please Print)

5 **** 2012 SHAUNAVON OPEN TAEKWONDO CHAMPIONSHIPS **** REFEREE REGISTRATION Tournament Date: Saturday, April 21, 2012 Name: Mailing Address: Daytime Telephone: Fax: Dojang: Master: Present Referee Class: (Please check appropriate box) Provincial: ; P Class ; 3 rd Class ; 2 nd Class ; 1 st Class National: ; P Class ; 3 rd Class ; 2 nd Class ; 1 st Class International: ; 3 rd Class ; 2 nd Class ; 1 st Class Send application to: OR Mr. Peter Allen P.O. Box 843 Shaunavon, Saskatchewan S0N 2M0 FAX: Pete (306) allenh2op@yahoo.ca

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