$40 - Novice and Black Belt Divisions. DIRECTOR: Jon Bertsch
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1 HOST: 6th Annual Western Conference Championships of the National Collegiate Judo Association University of California Martial Arts Program DATE: Saturday, February 24, 2018 LOCATION: Recreational Sports Facility Field House, University of California, Berkeley 2301 Bancroft Way Berkeley, CA SANCTION: USA Judo #15904 SCHEDULE: Saturday, February 24, 2018 Registration and Weigh-ins Referee Meeting Competition begins ENTRY FEE: $40 - Novice and Black Belt Divisions DIRECTOR: Jon Bertsch HEAD REFEREE: DIVISIONS: MATCH TIMES: RULES: jonti.bertsch@gmail.com David Williams, IJF A 9:00 AM-11:00 PM 11:00 PM 12:00 Noon Novice Division (below Sankyu) Males: 60kg, 66kg, 73kg, 81kg, 90kg, 100kg, +100kg Females: 48kg, 52kg, 57kg, 63kg, 70kg, 78kg, +78kg Standard Division (Sankyu or above) Males: 60kg, 66kg, 73kg, 81kg, 90kg, 100kg, +100kg Females: 48kg, 52kg, 57kg, 63kg, 70kg, 78kg, +78kg Black Belt Division: Match length: 4 Minutes Judo Gi: Blue & White Gi Encouraged. Only White Gi Required. Novice Division (below San Kyu): Match length: 4 Minutes Judo Gi: Blue & White Gi Encouraged. Only White Gi Required. BLUE AND WHITE BELTS WILL NOT BE PROVIDED New IJF rules with modifications will apply and there will be Kansetsu Waza in all divisions, Novice and Black belt. Clarification will be provided at the Referee s Meeting. Competition Method: Round Robin in all divisions. Golden Score (unlimited) will be used in all matches.
2 Eligibility: National Collegiate Judo Association Rules of Eligibility Students must meet the following Criteria: 1. Be a member in good standing with USA Judo (United States Judo Inc.) or other recognized organization (USJA, USJF, ATJA). A copy of your current membership card will be required at registration 2. Is at least fifteen (17) years of age as of the date of the tournament and under the age of 25 as of the date of the tournament. Proof of age consisting of birth certificate, passport, or current USA Judo membership card having the age verification symbol V printed following the date of birth. Note: A Driver s License is not acceptable as proof of age. 3. Is currently enrolled as a full-time Student in an undergraduate program as defined by their institution. The student must carry no less than 12 semester hours or 12 quarter hours, nor have received or satisfied the requirements for a baccalaureate degree. A Student with eligibility in his/her final semester graduating at the end of term with less than 12 units is eligible. A student who is enrolled in a graduate program at the institution from which he/she earned an undergraduate degree is allowed to participate so long as he/ she has remaining eligibility and participates within the applicable 5 year period. 4. Must show legitimate progress toward graduation. Each year is recognized at the beginning of the academic year to include any summer school work completed. At the beginning of each year of collegiate enrollment, the student must have completed the units toward a designated degree program. By the beginning of the second year, a student must have completed and passed 15% of the requirements. By the beginning of the 3rd a student must have completed and passes 30% of the requirements. By the beginning of the 4th year, a student must have completed and passed 60% of the requirements. By the beginning of the 5th year, a student must have completed and passed 85% of the requirements 5. Student is eligible to compete in 4 (Seasons) within 5 Consecutive years of participation (10 semester s or 15 quarters) at a 4 year College or University or 2 seasons within 3 consecutive Calendar years (5 semesters or 8 quarters) at a junior (2 year) college. These time limits are calculated from the student s original date of matriculation. A Student Shall not be Subject to transfer qualifications if: a. Student changed institutions in order to continue to participate in judo because judo was dropped as a sport from the previous institution. b. There was no organized judo at previous organization. c. The transfer is a result of enhanced educational opportunities. Written verification from previous coach that the student left the first program in good standing must be obtained. Ineligibility - The NCJA Eligibility Committee will judge all exceptions on merit with no guarantee of participation. a. If the student does not meet the unit standards required, then he/she becomes ineligible for competition until the student meets the unit standards. b. If it is determined that the student was ineligible prior to competition due to misrepresented or forged documents, then he/she will, at a minimum, forfeit any medal achieved at this tournament.
3 OFFICIAL ENTRY FORM 4th Annual Western Conference Championships Novice Division (below Sankyu) Entry fee: $40. Checks should be made payable to UC Regents Contestant s Name Last First M.I. Address City State Zip code FR SO JR SR 5+. circle one University Name Team Coach (print) I certify the above named student meets all of the eligibility requirements stated above. Team Coach - signature USA Judo, USJA, ATJA, or USJF # Expiration Date Rank Date of birth Age Sex Emergency contact name Emergency phone #
4 Novice Division (circle one) actual weight Males: Females: 55kg 60kg 66kg 73kg 81kg 90kg 100kg +100kg 44kg 48kg 52kg 57kg 63kg 70kg 78kg +78kg Signature Date NOVICE NOVICE NOVICE NOVICE NOVICE
5 OFFICIAL ENTRY FORM 4th Annual Western Conference Championships Black Belt Division Entry fee: $40. Checks should be made payable to UC Regents Contestant s Name Last First M.I. Address City State Zip code FR SO JR SR 5+ circle one University Name Team Coach (print) I certify the above named student meets all of the eligibility requirements stated above. Team Coach - signature USA Judo, USJA, ATJA, or USJF # Expiration Date Rank Date of birth Age Sex Emergency contact name Emergency phone #
6 Black Belt Division (circle one) actual weight Males: Females: 55kg 60kg 66kg 73kg 81kg 90kg 100kg +100kg 44kg 48kg 52kg 57kg 63kg 70kg 78kg +78kg Signature Date BLACK BELT BLACK BELT BLACK BELT BLACK BELT
7 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, the 4 th Annual Western Conference Championships, and in any Judo tournament, practice, clinic, and related events and activities of the United States Judo, Inc.; United States Judo Association, Inc.; ATJA; United States Judo Federation, Inc.; National Collegiate Judo Association; University of California Berkeley, UC Berkeley Campus Recreation and Unions, UC Berkeley RSF, UC Berkeley Judo, UC Martial Arts Program and its officers and all judo organizations and local organizations supporting the event, I hereby: 1. Acknowledge that I am familiar with the sport of Judo and understand the rules governing the sport of Judo. 2. 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, supervisor, and/or a tournament official of such conditions 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 (TBI) or death, and severe social and economic losses due not only to my own actions, inactions or negligence, but also to the actions, inactions, 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. 4. Knowing the risks involved in the sport of Judo, I assume all such risks and accept personal responsibility for the damages following such injury, permanent disability, or death. 5. Release, waive, discharge and covenant not to sue the United States Judo, Inc.; United States Judo Association, Inc.; United States Judo Federation, Inc.; National Collegiate Judo Association; University of California Berkeley, UC Berkeley Campus Recreation and Unions, UC Berkeley RSF, UC Berkeley Judo, UC Martial Arts Program and all judo organizations and local organizations supporting the event, together with 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, guardians, supervisors and coaches, sponsoring agencies, sponsors, advertisers, and if applicable, owners, lessors, and lessees of premises used in conducting 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 18 YEARS OF AGE, OR, IF I AM UNDER 18 YEARS OF AGE, I HAVE OBTAINED THE REQUIRED CONSENT OF MY PARENT/GUARDIAN AS EVIDENCED BY THEIR SIGNATURE BELOW. Participant Participant s Signature Date
8 FOR PARENTS/GUARDIANS OF PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 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 incident 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 tile above warnings and conditions and their ramifications. Print Name of Parent/Guardian Signature of Parent/Guardian Date CERTIFICATE REGARDING NON-BLACK BELT CONTESTANTS I,, (Name of Instructor) a Judo Instructor, who has been awarded the Judo rank of Shodan or higher, recognized by United States Judo, Inc., hereby certify that, although not having been awarded the Judo rank of Shodan or higher, is of sufficient aptitude and skill in Judo to compete in these Championships. Signature of Judo Instructor POWER OF ATTORNEY If contestant if under the age of 18 years, this document must completed by the contestant s parent or legal guardian if the parent or legal guardian is not attending the Championships. I certify that I am the parent or legal guardian of a minor. I will not be in attendance at the Championships and do hereby designate, who is over 21 years of age, to be my true and lawful attorney, to act in my name, place, and stead, to do any and every act and exercise any power that I might or could do or exercise through any other person and that he/she shall deem proper or advisable, intending hereby to vest in the person acting for me full power and authority to do and perform all and every act and thing. Signature of Parent or Legal Guardian
9
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